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    We’ll likely never know the real story, of course, as fans, and not insiders, but it really doesn’t add up to me. Not at all. Why they gave up on Goff. Why he went from hero to zero in such a short time. And I don’t get why the Eagles managed to trade Wentz for a plus plus package, when he, arguably, was a truly “busted” QB and Goff wasn’t/isn’t, and Goff is two years younger.

    Not getting it.

    The Rams gave up a ton to get Goff in the first place, and then a ton to get rid of him. Total picks lost (plus Goff) has to be up there among all time screw-ups and lost opportunities.

    IMO, some NFL commentators seem to dismiss draft picks lost in trades, cuz they don’t talk about them as actual players you don’t get to add to your roster. Those picks could have turned into much needed offensive and defensive line help, wideouts, linebackers, safeties, etc. They weren’t just pieces of paper. Those are all lost chances to upgrade your team, in exchange for a far more narrow and limited chance to upgrade your team.

    To beat a dead horse. Not a fan of this. Not a fan.

    Goff is still Goff. They needed to work with him, build back his confidence, replace the loss of Gurley, and add a speedster who can also win jump balls. They could have done that with the picks they traded away, and better, more patient coaching, in my view.

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    The top 11 edge-rushers in the 2021 draft class

    * https://touchdownwire.usatoday.com/lists/2021-nfl-draft-edge-rushers-jaelan-phillips-azeez-ojulari-kwity-paye/

    A story I relate often comes to us from the 2013 NFL draft, and is the perfect way to begin this article. Early on night one the Miami Dolphins traded up with the then-Oakland Raiders to select Dion Jordan, the pass rusher from Oregon. When the pick was made Mike Mayock, now the general manager for the Raiders, stated that the move told us something about the state of professional football. Paraphrasing here, Mayock stated that the most important place on the field was the pocket. Teams need players that can throw from that spot, that can protect that spot, and that can attack that spot.

    That remains true today. Think about how this draft is expected to unfold, with potentially four quarterbacks off the board with the first four picks, and then two offensive linemen shortly thereafter.

    But what about the players who can attack that spot?

    This is an intriguing EDGE class, if an incomplete one. It lacks the surefire prospect at the top, the complete player that you know can step in and produce without reservation. If you are looking for a Chase Young or Jadeveon Clowney or a Bosa Brother at the top of the board, you might be out of luck.

    That does not mean, however, this class lacks talent. Far from it, in fact. The only issue is that you might need to sacrifice a trait or take a gamble on development. If you get the evaluation and the fit right, you might just find that player to attack the spot.

    Here are the top 11 EDGE prospects in the 2021 draft class.

    1. Jaelan Phillips, Miami

    Height: 6’5″ (92nd) Weight: 260 (51st)
    40-Yard Dash: 4.56 seconds (93rd)
    Bench Press: 21 reps (39th)
    Vertical Jump: 36 inches (81st)
    Broad Jump: 125 inches (90th)
    3-Cone Drill: 7.01 seconds (80th)
    20-Yard Shuttle: 4.13 seconds (96th)

    Bio: Once upon a time Jaelan Phillips was the top recruit in all of high school football. Graded as a five-star prospect out of Redlands East Valley High School in Redlands, California by 247sports, Phillips had no shortage of interested programs knocking down his door. He was considered the top player at his position, and the top overall prospect by 247sports.com. Phillips committed to play at UCLA, and unfortunately his career with the Bruins did not match his potential. He played in seven games as a true freshman in 2017, and the following season he appeared in just four before a concussion ended his sophomore campaign.

    And his time at UCLA.

    In December of 2018, following three concussions, Phillips retired from football. Coming from a musical family (his grandfather Jon Robinson is a critically acclaimed pianist and conductor, his mother plays the cello and his father plays the trumpet) Phillips enrolled at Miami and entered the Frost School of Music. But the passion for the game was still there, so he returned to the field for the Hurricanes and this past season looked like the former top-rated recruit. He notched 45 total tackles (15.5 for a loss) and eight sacks in one season, and now stands as perhaps the top prospect at his position yet again.

    Stat to Know: Pro Football Focus charted Phillips with 36 total pressures over his final seven college games.

    Strengths: Between the lines, Phillips is a rather easy evaluation. It should be no surprise that a former five-star recruit (and once the top prospect in the country) is good at football. Phillips is solid against the run, with good awareness and vision on the edge and the ability to use his hands and upper-body strength to lock out blockers while he identifies the run design and seeks out the ball carrier. He shows good awareness and feel against traps, pulls and zone designs when the slice block from the backside is coming his way. Phillips also displays good discipline on jet sweeps and end arounds, fighting to keep contain.

    But if you are drafting an EDGE you want a pass rusher, and Phillips certainly delivers in that regard. He has a great compliment of moves off the edge, including cross-chops, swims and spins, as well as the ability to counter the tackle late in the play. He is explosive off the line, particularly when given the green light to slant or stunt to the inside. His film is replete with examples of him cutting inside and beating tackles and even guards to the spot. He even shows the ability to dip and bend, an essential trait for pass rushers.

    Phillips also has the size and quickness to kick inside on passing downs or in sub packages. There are a number of examples from 2020 of this trait, particularly early against Duke where his quick, violent swim move led to immediate pressure on a number of downs. He also kicked inside to NT on a few snaps (PFF charted him with four snaps in the A-Gap this past season) and you can envision some defensive coordinators using him as the single lineman in some 1-5-5 or 1-4-6 sub packages. Patrick Graham might love to get his hands on Phillips.

    Weaknesses: As mentioned above, the football part is the easy piece to the evaluation. His main weaknesses stem from the off-the-field portion, which is something that a chucklehead like me cannot answer with any certainty. There is a medical history with Phillips that is hard to ignore. In addition to the three concussions — which led to his medical retirement — there is also a broken wrist suffered during a scooter accident during his time at UCLA. Teams are going to want to drill down on the medical side before making him a first-round pick.

    There is one small, nitpicky thing with him that shows up on film, mostly when he is in a two-point stance. Phillips will sometimes false step, picking up his lead foot at the snap and dropping it right back down. That costs him a split-second off the line of scrimmage. It did not hurt him at Miami — and he is much more explosive in a three-point stance — but every split-second counts on Sundays.

    Conclusion: If teams are satisfied from a medical perspective, this is an easy selection. The talent and potential is there for Phillips to be a dominant player off the edge at the NFL level, and he also offers discipline and awareness against the run, making him a complete package. His ability to dominate on the inside with his quickness and array of pass-rushing moves makes him an asset on every down in the league.

    Comparison: Mike Renner of PFF went with Frank Clark as a comparison, which seems applicable to Phillips and what he offers at the next level.

    Resources: For more on what Phillips offers off the edge you can check out this piece on Phillips and the “pass rushing plan.”

    2. Azeez Ojulari, Georgia

    Height: 6’2″ (17th) Weight: 249 (26th)
    40-Yard Dash: 4.60 seconds (88th)
    Bench Press: N/A
    Vertical Jump: N/A
    Broad Jump: 124 inches (94th)
    3-Cone Drill: N/A
    20-Yard Shuttle: N/A

    Bio: ESPN graded Azeez Ojulari as a four-star recruit from Marietta High School in Marietta, Georgia, and Ojulari was coveted by a number of SEC schools including Alabama, Forida and Auburn. He chose Georgia, staying in-state to play his college ball. But due to an ACL tear suffered during his final season at Marietta, Ojulari played in just two games in 2018 as a freshman and ultimately redshirted. He returned to the field for 2019 and appeared in all of Georgia’s games, notching 33 tackles and 5.5 sacks.

    This past season his production exploded, as in just ten games Ojulari recorded 31 total tackles (including 12.5 for a loss, a career-high) and another career-best mark with 9.5 sacks.

    Stat to Know: Ojulari is a true “EDGE,” as Pro Football Focus charted him with just one snap in the A- or B-Gaps over his three-year career.

    Strengths: Speed is the name of Ojulari’s game. While some other prospects in this class have more power few — if any — can match what Ojulari offers around the corner. Ojulari has tremendous explosiveness and quickness off the edge, with an impressive first step and the ability to turn the corner and flatten to the quarterback. His hands are very impressive, has he can chop/rip/swat against most tackles and there are some reps where he just leaves the tackle in his wake.

    He is still filling out his plan as a rusher, and there are moments where you would love to see him come up with a better counter or Plan B, but you can find some good examples of him figuring this out if you look. On one play against Missouri he initially punches with his left hand to attempt a long-arm move, but when the tackle handles that he immediately dips to the inside and is able to put a big hit on the QB. Another example is from his game against Mississippi State where the left tackle does not bite on his Euro step move, so Ojulari immediately tries to counter with a long-arm move.

    But as he figures out how to effectively counter, his ability to win with speed and quickness will serve him well. That explosive first step gives him an advantage around the outside against most tackles, and also helps him when freed up to slant or stunt to the inside. His athleticism and ability to corner make him a solid prospect at the position. Another solid trait of his is his length. At Georgia’s pro day Ojulari measured in with 34.38 inch arms, placing him in the 84th percentile among EDGE prospects. That shows up when he turns to the long-arm move.

    Finally, that Mississippi State game is a fascinating study. The Bulldogs used a number of three-man fronts to try and slow down MSU’s Air Raid offense, which led to Ojulari facing a lot of double-teams.

    Weaknesses: Given his reliance on speed, power is a part of his game that needs to be filled out. His initial plan of attack on almost every play is to try and win with quickness, and while that often worked on Saturdays he’ll need a more complete package to win consistently on Sundays. There are moments when tackles got their hands on him, and the play was over before it began.

    Ojulari is also a pure EDGE right now, and is not someone you can see kicking inside on sub packages or on passing downs. He was also part of a deep rotation at Georgia at the position, and as PFF noted he never played more than 52 snaps in a game. That led to a number of plays where he had fresh legs, relatively speaking. It also led to the tremendous finish to his college career against Cincinnati in the Peach Bowl, where he put together a number of sacks in the final half of play including a safety on his final collegiate snap. There could also be questions about whether he is better suited for an off-ball, OLB role rather than as a player with his hand in the dirt.

    Conclusion: There is always room for a player who can corner, bend and get to the quarterback. Ojulari’s quickness gives him a true trump card that will work at the next level. He might not have the full array of moves under his belt, but you can see him starting to piece it all together. His length will also serve him well on Sundays in the league. He might be a pure outside-only player but his quickness and explosiveness is worth an early pick.

    Comparison: Ojulari’s size, frame and athleticism remind me a bit of Marcus Davenport, who had a stunning first-round rise and was ultimately drafted by the New Orleans Saints who traded up to do so. Ojulari is seeing a similar rise, building off his Peach Bowl performance.

    3. Kwity Paye, Michigan

    Height: 6’2″ (18th) Weight: 261 (54th)
    40-Yard Dash: 4.52 seconds (97th)
    Bench Press: 36 reps (99th)
    Vertical Jump: 35.5 inches (76th)
    Broad Jump: 118 inches (61st)
    3-Cone Drill: N/A
    20-Yard Shuttle: N/A

    Bio: Kwity Pay was born in a refugee camp following the First Liberian Civil War. He was named after his father, who died in the conflict, and his mother brought him and Kwity’s brother Komotay to Rhode Island when Kwity was just six months old. He developed a passion for football and played both running back and defensive end in high school, and was named Rhode Island’s Gatorade Player of the Year as a senior in 2016. Considered a three-star recruit he turned down offers from northeast schools such as Boston College, Rutgers and Syracuse to play for the Michigan Wolverines.

    Paye was an immediate contributor for Michigan as a true freshman, playing in nine game and recording a sack. His breakout season was as a junior in 2019, where he notched a career-high 6.5 sacks. In the COVID-shortened 2020 season Paye still managed to record a pair of sacks.

    Stat to Know: Paye made Bruce Feldman’s “Freaks” list prior to this past season, and with 36 bench reps (99th percentile) and a 4.52 40-yard dash (97th percentile) you can see why.

    Strengths: For the most part, that freakish athleticism translates to film. He is powerful off the edge or even in the interior, with hands and upper-body strength to rock defenders off the snap and control them if necessary. He can also convert speed-to-power off the edge, and has a bull rush move that can drive even the best blockers back into the pocket.

    On film Paye did some of his best work against the run, with the ability to stack/shed blockers and identify the target in the backfield. That is where those 36 reps on the bench show up, as he can lock out and control blockers while finding the ball-carrier behind them. He also shows good discipline against traps and can scrape off blockers well to get the to running back. He also works on the outside to set the edge against the run, and knows where his help is coming from in those situations.

    I also love what he did against zone read teams, as he remained assignment sound and if the play went away from him, you cannot question his effort. His film is filled with effort plays both against the run and when rushing the passer.

    He is building out his toolkit as a pass rusher, but you can see a variety of moves being developed. His bull rush is perhaps his best move — due to his power — but you can find examples of him using a push/pull, a rip/dip, a long-arm or even the occasional swim move.

    Weaknesses: There are moments when his hands are a bit slow off the line, which enabled some tackles to get into him and control him through the play. Some have questioned his ability to put together a plan, or to come up with counters, but there are some examples. Against Michigan State this past season he flashed a long-arm at the start of one play before immediately changing into a rip/dip move based on how the tackle set against him. There is another example of him flashing a cross-chop and again turning to the rip/dip move as a counter attack. Still, there is room for growth here.

    Despite his strength and ability to kick inside, there were moments when he got swallowed up by interior offensive lines. Keeping him on the edge might be a better course of action at the next level.

    Conclusion: Ultimately, Paye might offer a better floor than the two prospects above him, and teams might find that enticing at the next level. He does not have the medical concerns that you find with Jaelan Phillips, and he is already built for the NFL game unlike Azeez Ojulari who still needs to add some strength and power to his arsenal. He has played on the interior so he offers some versatility, and while I do think he is better off the edge teams are going to value that from him.

    Comparison: Jordan Reid of The Draft Network sees some Brandon Graham in Paye’s game and profile, and that does make sense. Paye, however, goes with a different comparison and tries to model his game after Yannick Ngakoue.

    4. Joseph Ossai, Texas

    Height: 6’3 5/8″ (58th) Weight: 256 (44th)
    40-Yard Dash: 4.65 seconds (80th)
    Bench Press: 19 reps (21st)
    Vertical Jump: 41.5 inches (99th)
    Broad Jump: 131.5 inches (99th)
    3-Cone Drill: N/A
    20-Yard Shuttle: N/A

    Bio: Joseph Ossai was born in Nigeria, and moved to Texas with his family when he was ten years old. He was graded as a four-star recruit by 247sports.com, choosing to play for the University of Texas over schools like Notre Dame, Oregon and Texas A&M. He was a contributor immediately on campus, playing in every game as a true freshman and recording a sack and a forced fumble. As a sophomore in 2019 he played in 13 games, tallying 90 total tackles (13.5 for a loss) and five sacks. He also added a pair of interceptions. He was named the MVP of the 2019 Alamo Bowl after his three-sack performance. In the nine games of his junior season he added another 5.5 sacks, including three in a win over Oklahoma State.

    Stat to Know: Pro Football Focus charted him with three-plus pressures in seven of Texas’ nine games this season.

    Strengths: At the outset you should understand that I might be higher on Ossai than consensus. PFF graded him as a third-round prospect, and Jon Ledyard — whose opinion I value particularly when it comes to EDGE players — has him as the sixth-best EDGE in the class. This is part of what he wrote: “Ossai might be the ultimate boom-or-bust edge prospect in this class, so like a true coward I’ve planted my flag right between the polarizing grades on him.”

    I am going to plant that flag, and here is why. I think Ossai is just scratching the surface of what he can be at the next level, and you cannot match his athleticism and his effort. He is explosive off the line — and can improve in this area as we will discuss — and is adept at cornering of the edge. He is building out a complete set of pass rushing moves, but you can see examples of rip/dips, push/pulls, swim moves and even a bull rush or two. His first step is impressive, particularly when he can cut inside off the snap.

    You also will not outwork him. His motor runs hot on every play from snap to whistle, and whether double- or even triple-teamed, he is going to fight to the football. Against the run he will stack and shed and use his hands to keep fighting while getting his eyes on the football.

    Ossai started in more of an off-ball role before transitioning to a defensive end this past season, but Texas still found times to drop him into coverage in both zone and man coverage schemes. That versatility is going to be a plus for him as teams could use him in a few different roles

    Weaknesses: Ossai is still learning it seems, given the position switch this past season, and that has led to some snap hesitation on plays. This is something that Benjamin Solak has explored, and I have done work on as well. Here is what Solak put together:

    If he cleans this up, you are talking about a potential home run pick. The problem? The phenomenon of “coach-it-up-itis,” which is a term I’ve come up with to outline the belief that everything can get fixed with coaching. Is it possible? Sure. Is it a safe bet? Maybe not.

    In addition to the above, Ossai could use his hands better, particularly when facing cut block attempts. I would love to see him flare out the hands and drive would-be blockers to the turf to keep his legs and ankles clear.

    Conclusion: Ultimately, Ossai is one of my favorite prospects in the draft because you can see the potential. Maybe the allure of what he can be, and the phenomenon of “coach-it-up-itis,” is clouding my judgement. But I look at what he is now, where he is athletically, and think with just a bit of refinement to his approach you are talking about a double-digit sack player in the NFL. Can it happen? Maybe, maybe not. But sometimes in the draft you have to roll the dice and this is a bet I’m willing to make.

    Comparison: In a recent mock draft I had the Baltimore Ravens drafting him as a potential Matthew Judon replacement, and there is a reason…

    Resources: After Ossai’s incredible pro day I put together this piece on him, that dives into that snap hesitation and his upside.

    5. Jayson Oweh, Penn State

    Height: 6’5 7/8″ (78th) Weight: 257 (46th)
    40-Yard Dash: 4.39 seconds (100th)
    Bench Press: 21 reps (39th)
    Vertical Jump: 40 inches (96th)
    Broad Jump: 134 inches (100th)
    3-Cone Drill: 6.84 seconds (96th)
    20-Yard Shuttle: 4.15 seconds (95th)

    Bio: Jayson Oweh played his high school football at Blair Academy in Blairstown, New Jersey. Considered a four-star recruit by ESPN, who also graded him as the second-best player in the state and 94th overall, Oweh had offers from a number of Big Ten schools including Ohio State and Michigan. He went to Penn State and was a rotational player as a true freshman, notching a pair of sacks. That continued in 2019, where he made one start and added five sacks to his resume.

    The production was not there in 2020, as Oweh was held without a sack for the first time in his career. As we will see, that does not tell the whole story…

    Stat to Know: While Joseph Ossai was the clubhouse leader for “best pro day from an EDGE prospect” Oweh took that — unofficial — title from him after his performance a few weeks ago. Both his broad jump and 40-yard dash placed him in the 100th percentile among players at his position. He was named to Bruce Feldman’s “freaks” list two seasons in a row for a good reason.

    Strengths: Athleticism is the trait that simply jumps off the film. Some might not know this about me but for a few seasons I covered the Minnesota Golden Gophers for the Rivals network. Part of my job was to write about the upcoming opponent in a “Scouting Notebook” series, where I would study the upcoming offense and defense and break down each player the Golden Gophers would face.

    Here is what I wrote about Oweh two years ago when discussing their pass rush: “The only one who really stands out is Oweh. He had a very good pass rush rep late in the game against Michigan State with impressive speed off the edge. He runs the arc and then rips to the inside to get a sack/fumble.”

    That remains true to this day. His athleticism and speed off the edge is great, almost elite. But he also has some power to his game, and can pack a punch with his hands. On one play against Ohio State this past season he drove the guard back in to the lap of the quarterback, so he is not just a finesse/speed player. Against the run he shows good vision and does a good job of stacking and shedding blockers. He is also disciplined against zone read designs.

    He can be a weapon on stunts to the inside. When Penn State tasked him with slicing inside he was often able to get immediate pressure on the opposing passer. Oweh can also chase down plays from behind due to his impressive speed and the effort he puts into each snap.

    Weaknesses: The first question is the production element. How could a player with these tools and traits not record a single sack? Some if it was scheme, as he did see his share of double-teams and chips from tight ends. But there were also moments when the pressure did not result in a sack, due to elusive quarterbacks. For those who believe pressure is production, however, you can make the case that despite the lack of sacks Oweh’s 2020 season was still production.

    Oweh also relies on his athleticism more as a pass rusher, rather than technique. I did not see a lot of evidence that he can string together moves, counter blocks and pass sets, and win in the technical game.

    Conclusion: With athleticism like this, however, who cares about the technical side? Of course that is a rather glib statement but when you see Oweh and what he can do athletically, you can talk yourself into draft him early and molding him into a more complete player. You can refine pass rushing technique over time, you cannot teach his athleticism and explosiveness off the edge.

    Comparison: PFF’s Mike Renner went with Montez Sweat, which might be a perfect comp.

    6. Quincy Roche, Miami

    Height: 6’3″ (33rd) Weight: 243 (13th)
    40-Yard Dash: 4.68 seconds (72nd)
    Bench Press: 23 reps (56th)
    Vertical Jump: 32.5 inches (41st)
    Broad Jump: N/A
    3-Cone Drill: N/A
    20-Yard Shuttle: N/A

    Bio: Hailing from Owings Mills, Maryland, Quincy Roche was a standout defensive end and tight end at New Town High School. A three-star recruit according to 247sports.com, he entertained offers from smaller schools such as Appalachian State and Toledo before enrolling at Temple. Roche was an impact player for the Owls from the day he set foot on campus, notching seven sacks as a true freshman. His best season by far was back in 2019, when he tallied 13 sacks and was named the American Athletic Conference Defensive Player of the Year as well as a First-Team All-AAC player. He transferred to Miami for his final year of eligibility as a graduate, and he added another 45 tackles and 4.5 sacks to his resume, this time as an ACC player.

    Stat to Know: According to Pro Football Focus Roche’s 104 pressures the past two seasons made him the most productive pass rusher in all of college football.

    Strengths: Roche is a technically-advanced pass rusher that wins with effort, technique and experience. Given the number of games he has played and the different players he has seen, Roche is able to read and react to almost anything a tackle can throw at him. He can put together a variety of pass rushing moves, including cross-chops, swims, rips, and spins, and he can counter most pass blockers with an efficient plan of attack. Early against Duke this past season you saw that on a play where he initially tried to rip and dip around the edge, but hit the tackle with a counter/spin late in the down for a sack. His hands in that game against Duke were extremely impressive, particularly on cross-chop moves where he was leaving the Duke tackles in his wake.

    He is also adept at exploiting over-sets and mistakes by tackles. Against Pittsburgh this past season the tackle set too far to the outside exposing the inside gap, and Roche immediately identified that and attacked inside to generate pressure on the QB. In that game he also showed a bit of a Euro step on one snap, threatening the outside shoulder of the tackle and then cutting inside to force the QB off the spot. The Clemson game also provided some examples of Roche ironing out a long-arm move, adding one more element to his arsenal.

    Weaknesses: Roche is more technique than power or athleticism, and more experienced tackles might be better suited to handle what he attacks with off the edge. You even saw some of that this season in games against Virginia Tech and Clemson, when he was working against experienced and/or talented tackles who could handle his array of moves or simply beat him with power and/or athleticism. Speaking of which, athletically Roche does not compare well to some of the other prospects in this class, and he might be more of a finished product than players like Jayson Oweh or Joseph Ossai.

    Conclusion: Still, it is hard to argue with the production. Dating back to high school — Roche set a school record his senior year with 19 sacks — Roche has found ways to get to the quarterback. He might not duplicate those kinds of numbers in the NFL, but players with a knack for getting to the QB are still a valued part of a roster. He might not have the ceiling of other players on the draft, but the floor is rather solid.

    Comparison: I see a little of Trey Flowers in his game, a player who might rely on technique and need a bit of scheme help to produce at the next level.

    7. Rashad Weaver, Pittsburgh

    Height: 6’4″ (68th) Weight: 259 (49th)
    40-Yard Dash: 4.83 seconds (33rd)
    Bench Press: 20 reps (31st)
    Vertical Jump: 33 inches (41st)
    Broad Jump: 114 inches (36th)
    3-Cone Drill: 6.98 seconds (84th)
    20-Yard Shuttle: 4.30 seconds (74th)

    Bio: 247sports.com graded Rashad Weaver as just a two-star prospect coming out of Cooper City High School in Fort Lauderdale, Florida. Weaver played both basketball and football at Cooper City, and was a tight end and defensive end in the fall and a center on the hardwood. He originally committed to Michigan, but when he was informed that he would have to be a preferred walk-on, he switched his commitment to Pittsburgh. Weaver tallied three sacks as a redshirt freshman in 2017, and then 6.5 sacks as a sophomore in 2018. He was set for a breakout year as a junior in 2019 but tore his ACL prior to the season, missing the entire year. He came back for the 2020 campaign and tallied a career-high 7.5 sacks in just nine games.

    Stat to Know: The Panthers used him as a pure EDGE, as he saw just 14 snaps over the tackle — and nothing on the inside — this past season according to Pro Football Focus.

    Strengths: Weaver has length and he knows how to use it. He has great technique and hand usage, and his length makes his reliance on a long-arm move a natural fit. But he offers more than just that one move, as you can find examples of him winning with a swim move, a cross-chop, a rip/dip, and he can also bend around the arc to get to the quarterback. When it comes to countering tackles, his preferred method of attack is to counter-spin late in the down and he is effective when turning to that move.

    I enjoyed seeing Weaver work against the run, as he shows power at the point of attack and great hand technique. Tackles and other blocker who try and cut him are often found on the business ends of his hands, as he drives them face-down into the turf and evades the attempt. He has great awareness overall — against the run and the pass — and knows how to relate down when he sees the tackle down block, and he can initiate contact against traps and slice blocks.

    Recognition and awareness might be two of his strengths, as he can diagnose plays well and will sink under screens or designed throws to the flat. He also uses his length to disrupt passing lanes and force the QB to either reset or adjust his arm angle.

    Weaknesses: Weaver is another “floor” prospect, as there might not be a ton of room for growth. He wins with power, length and technique, and does that part of the job well. But the athletic profile does not offer a ton of hope for his upside. He tested well at his pro day, which might offer some potential, but his career arc might best be summed up in one play against Syracuse, where he uses fantastic technique to beat the tackler, but misses on the sack because he cannot change direction quickly enough. There was also an example of that against Clemson and Trevor Lawrence where he won with technique, but ended up falling on his back trying to chase the QB as he spun away from him. Maybe this is a case where the good testing numbers on his agility drills (4.30 short shuttle, 6.98 three-cone) overshadow moments like that on the field.

    Conclusion: NFL decision makers love safe floors, and that is what Weaver offers. That coupled with his awareness, recognition, work against the run and his discipline make him a safe option. His age and lack of burst might not provide an enticing ceiling, but you can see a path to him unlocking some effort sacks at the next level.

    Comparison: I can see a little bit of Deatrich Wise Jr. to Weaver’s game.

    8. Payton Turner, Houston

    Height: N/A Weight: N/A
    40-Yard Dash: N/A
    Bench Press: N/A
    Vertical Jump: N/A
    Broad Jump: N/A
    3-Cone Drill: N/A
    20-Yard Shuttle: N/A

    (Pro day scheduled for April 9).

    Bio: 247sports.com graded Payton Turner as a two-star prospect, and the 359-ranked player in the state of Texas alone. Coming out of Westside High School in Houston, Texas he entertained interest from Kansas, Purdue, Texas and Michigan but his only offer came from the Cougars, so Turner enrolled at Houston. Part of this might have been due to a knee injury his senior year which caused him to miss the bulk of his final prep season.

    Turner played immediately for the Cougars as a true freshman, tallying 14 tackles and an interception. He started the first 11 games of his sophomore year and while his season ended early due to a foot injury, he recorded 42 total tackles, including 3.5 for a loss. His final two years on campus saw him truly start to produce off the edge, as he recorded 3.5 sacks as a junior and five as a senior, in just five games due to the COVID-shortened year. Turner earned an invitation to this year’s Senior Bowl for his efforts.

    Stat to Know: Turner’s productivity increased every season. In addition to the big jump in sacks Turner notched a whopping 10.5 tackles for a loss in 2020, again in just five games. That beat his previous mark of 7.5 set in 2019 over a 12-game season.

    Strengths: There are often prospects that you come to late in the process, and wish you had spent time on earlier in the cycle. Payton Turner is one such player for me. But I am glad I took the time to study his tape. It is hard to find a more contrasting set of game than watching a pass rusher against BYU and then Navy, but watching those two contests gives you a flavor of what he can be against the run and when rushing the passer. Turner is powerful and violent off the snap, and shows power at the point of attack when working against the run. He does not quit until the whistle, and his game against Navy flashed a number of effort plays where he was chasing down runs from behind. He also displayed impressive change-of-direction skills on one counter option, when he spun back to mirror the QB and dragged him down for a tackle behind the line.

    Rushing the passer is what moves the needle for EDGE defenders, and Turner checks that box as well. He has a bevy of moves at his disposal, including rip/dip moves, an impressive cross-chop that he will pair with either a rip or a swim after if necessary, a push/pull move and he will even just rely on a bull rush if necessary. On one play against BYU’s right tackle he used that bull rush to just walk him back into Zach Wilson’s lap, influencing the QB’s arm angle.

    Turner also has quick hands, and when combined with his experience and array of moves he is a pass rusher with a clear plan. It is rare to see him use the same move on two consecutive snaps, and he is ready to counter the tackle should his initial move be stymied. He will use a spin or a late rip as a preferred method of countering, but really you can see him turn to a different Plan B from snap-to-snap. There are even some flashes of bend and cornering ability from him, which is also quite intriguing. Finally, given his experience if a tackle makes a mistake, he will make you pay.

    Turner is not the most athletic or bursty defender, but the size, frame and length when coupled with his experience and technique makes for a nice package.

    Weaknesses: Turner plays extremely high with his pads, and will need to either adjust his pad level or accept the fact that he will lose some reps when tackles get into his exposed chest. He is not the most explosive player off the edge, and he wins with effort, technique and experience. He also took advantage of the competition around him, and has just the two (or one-and-a-half) years of good production. He had success against BYU’s right tackle and at times against Brady Christensen, their left tackle who is going to get drafted this cycle, but the level of competition is an open question. His Senior Bowl week, however, should alleviate some of those fears.

    Then there is an injury history, both with the high school injury and the lower body injury that ended his sophomore season early.

    Conclusion: Still, his tool-kit as a rusher coupled with his ability to kick inside makes him an extremely enticing option, even early on Day Two of the draft. I love what he offers from a technical standpoint, and also what he demonstrates in terms of a plan of attack. My only regret is that I did not start watching him sooner.

    Comparison: I am getting an Adalius Thomas vibe from him, a player who when left to pressure the quarterback thrived, but when asked to do more in terms of coverage and playing in space struggled.

    9. Joe Tryon, Washington

    Height: 6’5″ (87th) Weight: 259 (49th)
    40-Yard Dash: 4.64 seconds (81st)
    Bench Press: 22 reps (47th)
    Vertical Jump: 35 inches (72nd)
    Broad Jump: 118 inches (61st)
    3-Cone Drill: 7.18 seconds (55th)
    20-Yard Shuttle: 4.36 seconds (60th)

    Bio: Joe Tryon was graded as a three-star recruit by ESPN’s scouting services, after playing at Hazen High School in Renton, Washington. He received a handful of offers from schools in the Pacific Northwest including Washington State, Oregon and Eastern Washington, and originally chose Washington State, but decided to flip his commitment and play for the in-state Huskies. He redshirted his freshman year but in 2018 he appeared in 12 games, notching 20 tackles and a sack. Tryon enjoyed a bit of a breakout in 2019, as he tallied eight sacks and was named a Second-Team All-Pac-12 player. That would be the end of his college career, as he opted-out for 2020 due to COVID-19.

    Stat to Know: Pro Football Focus charted him with 29 pressures in his final seven games during the 2019 season, which is a heck of a way to end your career.

    Strengths: There is a phrase in life: “Do one thing and do it well.” That could apply to Tryon and his mode of attack as a pass rusher, as he wins primarily with a speed-to-power bull rush off the edge. Forget evading you, he wants to run through you. It works on occasion, but what gives me more hope about his NFL career is what you are seeing him use to complement that move. You are seeing examples of him using cross-chops and even the occasional rip/dip move to add to the weapons in his bag.

    Tryon is another defender who is acutely aware of what could be coming his way, in terms of traps or slice blocks. He takes those on with violence, driving into the blocker and turning running plays back to the inside. He does not take a single snap off, and finishes every play to the whistle.

    Something I noticed with him, particularly in his game against Oregon in 2019, is how well he handled playing in space. He showed good awareness and feel for handling underneath zone coverages, passing off receivers, and making tackles in the open field. Could there be an unlocked OLB type waiting to be discovered at the next level? The idea intrigues me…

    Weaknesses: One of the biggest questions facing Tryon is the production angle. With some of the other players in this class with thin resumes, such as Gregory Rousseau, you have one year of elite production or execution to hang your hat on. Here, you have a year with eight sacks, many of which came as effort plays rather than due to his technique. Still, he is explosive on the outside and might have the versatility to play both on the inside and in space as just discussed. Again, you cannot teach size and frame, and Tryon checks those boxes. A creative defensive coordinator could find ways to involve him all over the defensive front and just unleash him on the opposing offensive line from a variety of alignments and angles. That works too in the NFL, last I checked.

    Conclusion: Teams will talk themselves into what Tryon could be, and if they do that in conjunction with the potential versatility he offers, that might be a smart bet. I think there is schematic versatility in that Tryon could be an off-ball OLB in a 3-4 base scheme with the potential to drop down as a defensive end in even fronts. You could also kick him to the inside on some sub packages. There are things to play with here, and that will be enticing on the second day of the draft.

    Comparison: Tryon could be a “boom/bust” type of player, and you can see a variety of outcomes for him. On the high end of that range you could be getting T.J. Watt-lite, a player who thrives in a role as an outside linebacker in a 3-4 base scheme who can primarily rush the passer but also handle coverage responsibilities. But how often are “high ends” realized? On the low end of the range you might get Daeshon Hall. Somewhere in the middle? Perhaps Dawuane Smoot, who has carved out a solid little role with the Jacksonville Jaguars.

    10. Gregory Rousseau, Miami

    Height: 6’7″ (98th) Weight: 266 (67th)
    40-Yard Dash: 4.69 seconds (71st)
    Bench Press: 21 reps (39th)
    Vertical Jump: 30 inches (14th)
    Broad Jump: 115 inches (42nd)
    3-Cone Drill: 7.50 seconds (16th)
    20-Yard Shuttle: 4.45 seconds (36th)

    Bio: Gregory Rousseau did it all for Champagnat Catholic School in Hialeah, Florida. He was a defensive end, safety and wide receiver for his high school football team, and helped Champagnat Catholic to its second state title in school history. As a senior he tallied 80 tackles and ten sacks, including three sacks in the state championship game. He also earned Second-Team All-State honors as a wide receiver, catching nine touchdowns in 2016. He enrolled at Miami and after playing in a few games as a true freshman, an ankle injury ended is season and he took a medical redshirt. He came back as a redshirt freshman in 2019 and exploded on the national stage with 15.5 sacks, earning ACC Defensive Rookie of the Year honors. He was also named a First-Team All-ACC player as well as a Second-Team All-American.

    Rousseau opted out of the 2020 season due to COVID-19.

    Stat to Know: Rousseau has just 546 career college snaps. That…requires a lot of projection.

    Strengths: Rousseau immediately checks the size, length and frame boxes. His length pops on film against the run and as a pass rusher, as he has developed a great long-arm move that shows up off the edge. He also has the ability to lock out blockers against the run, and loves to set the edge against run plays. Rousseau has long strides off the edge, which gets him into most tackles quickly in the down despite a lack of pure explosiveness. For a player of his size he has impressive footwork, and that shows up when tackles try to cut him, as he can quickly step back with ease and rely on his feet, rather than his hands, to evade cuts.

    Even with his frame, Rousseau has the ability to dip and bend around the arc with ease. He is disciplined against option plays and rarely bites on fakes. His power shows up on film, particularly when he uses that long-arm technique but also when he tries to overpower tackles with a bull rush attempt.

    Miami also kicked him inside — he saw 74 A-Gap snaps according to PFF charting — and he stood out in those opportunities. He seemed to generate immediate pressure on those occasions and perhaps even showed a bit more burst and explosiveness than he did on the outside.

    Weaknesses: I mentioned the 546 snaps, right? Because that is not an extensive body of work and there is a lot of projection that goes into what he could be at the next level. Beyond that, Rousseau is relatively new to being a pass rusher, having spent a lot of his prep days playing in the secondary and as a receiver. You can see a lot of false steps from him off the line, mostly when in a two-point stance, and you would like to see more from him in terms of a pass rushing plan and counter moves. If you are looking for a technically-sound option in this class, Rousseau might not be your top choice. He also relies mightily on a Euro-step move to the inside and he either wins with that…or doesn’t. Basham also has an upright playing style and high pad level, which allows some tackles to get into his frame and win the rep. Finally there are now questions about his athleticism, given his pro day performance.

    Conclusion: Still, for a team looking for a situational pass rusher with the chops to kick inside while they hope to fill in the rest of the blanks, Rousseau could be an enticing option. He might need a lot of development and coaching, but you cannot teach his size and frame. I know I know, the words of the wise Emory Hunt ring in my mind: “Size is not a skill.” Sometimes, however, it is enchanting…

    Comparison: Coming up with a comparison for Rousseau is tough, as most raw prospects rely more on athleticism than frame. This writeup of him uses Arik Armstead as a comparison which is the best I’ve found.

    11. Carlos Basham Jr., Wake Forest

    Height: 6’3″ (46th) Weight: 274 (81st)
    40-Yard Dash: 4.64 seconds (81st)
    Bench Press: 20 reps (30th)
    Vertical Jump: 34 inches (61st)
    Broad Jump: 122 inches (82nd)
    3-Cone Drill: 7.13 seconds (60th)
    20-Yard Shuttle: 4.25 seconds (84th)

    Bio: A standout on the gridiron and the hardwood for Northside High School in Roanoke, Virginia, Carlos “Boogie” Basham Jr. turned down offers from Pittsburgh and Cincinnati to enroll at Wake Forest. Basham redshirted his first year on campus but was a contributor the rest of his career for the Demon Deacons. He was named a First-Team All-ACC player as a junior in 2019 when he recorded 57 total tackles (18 for a loss) and ten sacks. He returned for one final season and appeared in six games, notching five sacks. Basham earned an invitation to the Senior Bowl and was one of the better performers down in Mobile.

    Stat to Know: Pro Football Focus charted Basham with just 35 B-Gap snaps this past season but operating inside could be critical to his future success.

    Strengths: Basham favors winning to the inside, which has its benefits and its curses. Smarter tackles who did their homework were patient on his initial attempt to threaten the outside and simply would ride down on him when he eventually tried to slice inside. But Wake Forest catered to that, using him on a lot of stunts and twists to free him up to the inside, and you would see his motor and his ability to swim to the inside. That might be his best move as a pass rusher, a swim move, which he uses often and is even more effective at implementing when kicked to the inside. Against Clemson this season he saw a few snaps as a three-technique and you saw that inside swim move work to pressure Trevor Lawrence.

    Basham is also an experience defender with great awareness, particularly against the run when he stays disciplined against zone read designs and has great feel for trap blocks and slice blocks on inside zone plays. He can either long-arm those blockers and keep his eyes on the play or initiate contact with them. He will fight to set the edge on runs to his side, and if you run away from him the motor never stops. Basham is more than able to chase plays down from the backside. I do not think you can question his competitive toughness. When you see him fighting against and through double-teams down 31-3 to Clemson, you check that box of the scouting report and move on.

    Weaknesses: I did not see a full array of pass-rushing moves, which is somewhat concerning given his experience. He flashed a few cross-chops and a spin move at times, but by far he wants to win to the inside either by design or with a swim move. He also seems to lack a plan off the edge, mostly in terms of how to counter what he sees from the tackle or when the tackle handles his initial move. It seems his favored approach is to simply outwork the opponent or try and fight to the inside.

    Conclusion: I believe Basham’s key to contributing immediately in the NFL is as a situational pass rusher on the interior. That is, at least to me, when he seemed to be at his best. Working against guards and centers with that swim move that he loves so much. He can offer interior pressure via that means while filling out the rest of his toolkit as a pass rusher off the edge.

    Comparison: Jon Ledyard compared him in a sense to Curtis Weaver, the Boise State product who was trying to figure things out last season from an execution and technical standpoint, and that comparison carries some weight.

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    from NFL pro day takeaways for the 2021 NFL draft: A coveted QB class, opt-out riddles, which prospects are rising

    https://www.espn.com/nfl/draft2021/story/_/id/31182317/nfl-pro-day-takeaways-2021-nfl-draft-coveted-qb-class-opt-riddles-which-prospects-rising

    No scouting combine. No in-person visits from prospects. No business as usual for those involved in the 2021 NFL draft.

    This is the second consecutive draft impacted by the COVID-19 pandemic, and teams have had little face-to-face time, scarce medical information, fewer games to review and just as many questions to answer as usual. In the months leading up to the draft, which begins April 29, there have been pro days and … a whole lot of hoping for the best with virtual meetings with prospects.

    With the bulk of those on-campus workouts now wrapped up, we scoured the results and found takeaways from the athletic testing numbers, quarterback throwing sessions, surprises and moments that wowed social media. Here’s everything you need to know from the 2021 pro days:

    How less medical information has changed the process

    The biggest loss for every team this year is what they covet most from the combine: the results of prospects’ medical exams. In most years, 330-plus players would receive one of the most extensive medical exams of their lives at the combine as medical staffs from each team have access to their medical records and can examine each in person.

    The prospects who are flagged are sent for more tests before they leave the combine. And those with the biggest injury questions are brought back to Indianapolis in the weeks before the draft for another exam.

    As a result, teams could have far less information on roughly 55% of the prospects who would have been invited to the combine in previous years. Some of the middle- to late-round players with injury questions who don’t make that top 150 could be impacted.

    Even a high-profile prospect such as Virginia Tech cornerback Caleb Farley, who recently had surgery on his back — an outpatient microdiscectomy, according to several teams — could see his draft status differ from projections if teams don’t find a comfort level with his recovery.

    Vanderbilt’s Dayo Odeyingbo, an intriguing, versatile pass-rusher who suffered a torn Achilles in January, could be impacted as well, with the worst-case scenario a fall into Day 3 for an injury he would have had examined multiple times in previous years.

    Another example is Duke cornerback Mark Gilbert, whose last full season on the field was 2017, when he led the ACC in passes defensed. He missed most of 2018 and all of 2019 due to hip surgery and then played in just two games last season (114 snaps in all) before he had right foot surgery. There are more wild cards than usual this year.

    Why the QB class is so coveted this year

    The quarterback math has always been difficult to wrestle with through the years.

    Most personnel executives will only, begrudgingly, concede during a season there might five or six “great” quarterbacks in the league at that particular moment. And then those same personnel executives act like there are that many future great quarterbacks in every draft.

    That’s in a normal year. The frenzy is in overdrive this year, as quarterbacks could be selected with each of the first four picks for the first time in history. One general manager contacted in recent weeks had predicted “the quarterback pro days will be more out there than usual.” Meaning any and all reactions to one throw here, one throw there, against air, may appear to have more meaning after several trips through the social media cycle than usual. It’s all aligned for history to be made.

    Six quarterbacks were selected in the first round of the 1983 draft, with the first (John Elway), the third (Jim Kelly) and the last (Dan Marino) picks fitted for gold jackets when their careers were over. The last time quarterbacks went 1-2-3 in the draft? It was 1999, when Tim Couch, Donovan McNabb and Akili Smith were picked.

    In 2018, four quarterbacks — Baker Mayfield (No. 1), Sam Darnold (No. 3), Josh Allen (No. 7) and Josh Rosen (No. 10) — were selected among the top 10 for the first time in seven decades. And last year, three went in the top 10: Joe Burrow (No. 1), Tua Tagovailoa (No. 4) and Justin Herbert (No. 5).

    One of the most glaring indicators that the struggle continues to be real at the top of the board is that quarterbacks went 1-2 in both 2015 and 2016 (Jameis Winston and Marcus Mariota in ’15, Jared Goff and Carson Wentz in ’16) and none of the four is still with his original team.

    With so much uncertainty this year, there’s a feeling in the league that the teams at the top of the board believe the time, environment and the prospects available create the perfect storm to roll the dice on a quarterback. So much so that if you averaged many of the actual grades on the top quarterbacks in this draft, they might fall something like this:

    Quarterbacks have always been selected well above their actual grades because, well, they’re quarterbacks. There is also the residual impact of the Bills trading up to No. 7 to select Allen in 2018, the year after the Chiefs had moved to No. 10 to select Patrick Mahomes. Those two teams made big trades and got their guys, and every other team has been watching closely.

    I reached out to roughly two dozen scouts and personnel executives in recent weeks for an unscientific poll to try to get a snapshot of how Round 1 will really go. These are the results, with quarterbacks listed in no specific order within each tier (there were a handful of those surveyed who said they would flip Lance and Jones, but agreed with the rest):

    So with only a few weeks to go until the draft begins, expect quarterbacks to remain the biggest talking point.

    Opt-out riddles: Another wrinkle in a strange year

    The prospects who opted out of the 2020 season due to the COVID-19 pandemic have teams relying on methods they’ve used in the past for prospects who missed the season before they entered the draft. Rob Gronkowski, who did not play his final season at Arizona due to a back injury, was a tidy 270-pound Super Bowl reminder that body of work is important in this process. He was the No. 42 overall pick in 2010.

    Evaluators have tried to make the best of what they saw at the Senior Bowl in January and the pro days of some of the opt-out players. Stanford’s Paulson Adebo, for example, is still a tough call for some as the two-time All-Pac 12 pick had an injury end his 2019 season nine starts in and he opted out in 2020.

    Overall, there will be some fluctuations between how the opt-out season impacts a variety of prospects, with each team having its own criteria for how those players are graded.

    Prospects who wowed at pro days

    Pro days are just one piece of the puzzle, and when scouts criticize the media for their evaluations of prospects, they will often say too much emphasis was placed on a pro day or combine workout and that one play made in a noncompetitive situation should not get as much love as it does.

    Here are a few of the non-quarterbacks who made the most of the showcase in recent weeks:

    Many people in the league came away from Northwestern’s pro day raving about how offensive tackle Rashawn Slater looked after missing a season. They got the confirmation they needed to make him a top-15 pick.

    Wisconsin-Whitewater lineman Quinn Meinerz didn’t get to play a game in 2020 because his team’s season was canceled. But he made the most of his Senior Bowl week, especially in the one-on-ones, and he followed that up with a top-shelf pro day on March 9, including a reliably timed sub-4.9 40-yard dash at 320 pounds and top times in shuttle drills.

    The game video showed Oklahoma center Creed Humphrey didn’t surrender a sack in 2020, and his pro day was stellar for his position, including shuttle drill times similar to those for a skill position player.

    Penn State edge rusher Jayson Oweh had a pro day one scout called “high-end ridiculous” as the 6-foot-5, 257-pounder had double-take numbers such as a 39½-inch vertical and a 40 time in the 4.3s. He is one of the biggest pro day/game tape question marks of this class because he finished last season without a sack.

    BYU wide receiver Micah Simon, a former prep quarterback, went undrafted in 2020 after COVID-19 forced his pro day to be canceled. He caught passes from Zach Wilson at BYU’s pro day this year and dropped a 4.3 40 on those in attendance. He was signed by the Panthers last week.

    Avatar photozn
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    Rating Every NFL Coach’s Chances to Survive the 2021 Season
    Our Coaching Survival Ratings are based on play-calling skills, coaching cachet, postseason success, intangibles and more.

    https://www.si.com/nfl/2021/03/26/nfl-coaches-survival-rating-2021-season

    …Coaching Survival Rating could combine what they’ve done in the past, their biggest strengths and their weaknesses, which is a better methodology than simply ranking them, no? A ranking could, with a few exceptions, be a descending list of last year’s standings. CSR factors in their ability to call plays in their area of strength, their cachet as a manager, their Super Bowl trips and wins, and how respected and needed they are within the context of their environment. For example, there may be two coaches with the exact same record last year but wildly different CSRs because one is newly hired, one was a big hire, one has a longer contract, one is closely tied in with ownership, etc.

    Basically, what is their ability on a scale of one to 10 to survive a really bad season, and why?

    One housekeeping note: We have omitted all of 2021’s new coaches, as they’ll all be working from a theoretically clean slate except for David Culley in Houston, who has a Sisyphean journey ahead of him.

    TIER 1
    Bill Belichick, Patriots
    CSR: 10.0

    Greatest head coach in modern NFL history
    Defensive schematic genius with black ops military ties
    Eight Super Bowl rings
    If the Patriots went 0–16 next year, insisting on fielding a team of unpadded folk singers instead of football players, his motives would not (and should not) be questioned. Belichick is as untouchable in the NFL as untouchable gets.

    Andy Reid, Chiefs
    CSR: 9.8

    Riding the wave of cutting-edge NFL offenses
    Has the ear of the NFL’s most promising young talent
    Affable, honest lover of meats in a great food city
    It would be hard to imagine the NFL or the Chiefs without Reid. So many coaches eventually go stale, but the beautiful thing about Reid is his commitment to learning new ideas. That, and a front office that shares his desire to layer the offense with more playmakers than a defense can handle. Reid’s arrival in Kansas City signaled one of the most significant culture changes in modern NFL history. With consecutive Super Bowl appearances under his belt, he is as close to being an institution in his city as any coach not named Bill Belichick.

    Sean Payton, Saints
    CSR: 9.6

    Fields consistently good-to-great teams
    Super Bowl title
    Expert troll
    Payton’s choice to coach the Saints at a time when the city and fan base was reeling will never be forgotten. Like Reid, he is on the cutting edge of NFL offensive thinking and has the cachet to get the roster he wants year in and year out, salary cap be damned. Payton could come out and denounce gumbo, jazz music and drinking in public and still be a beloved figure in his adopted home city.

    Mike Tomlin, Steelers
    CSR: 9.6

    Two Super Bowl appearances, one victory
    Has never had a losing season in the NFL
    Rolodex of great sayings
    Tomlin will forever be underappreciated by Steeler Nation despite doing more than his fair share living up to Bill Cowher’s legacy. Tomlin’s worst year came in 2019 when the club went 8–8 with a combination of Mason Rudolph and Duck Hodges at quarterback. Last year’s team ran out of steam at the tail end of the season, though with a quarterback pushing 40 and an offensive line coming to terms with its own age, there were few other scenarios more inevitable.

    Pete Carroll, Seahawks
    CSR: 9.1

    Two Super Bowl appearances, one victory
    Creator of generation-defining defensive scheme
    Endless fount of positivity
    Seattle’s power structure is unique, and Carroll’s standing reflects his status as a personnel lead. His recent combativeness with Russell Wilson is interesting in that both sides seem to be putting a bit of their legacy on the line to get what they want. Will Carroll and his desire for a more measured and conservative offense win out? Will Wilson’s incredible talent win out? Carroll also has a pair of championships at USC to boost his résumé.

    John Harbaugh, Ravens
    CSR: 9.0

    Super Bowl title
    Employs one of the most creative offenses and defenses in the NFL while also staffing one of the league’s most robust and powerful analytics outfits
    Only current NFL head coach named John to spell his name with an ‘H’ in it
    Harbaugh’s transformation during the Lamar Jackson era cemented his staying power in Baltimore, something the Ravens may have realized concretely back in late 2018, when it seemed like Harbaugh would take his talents elsewhere. The line of teams waiting at his doorstep was probably an indicator of how he’s thought of throughout the league.

    Bruce Arians, Buccaneers
    CSR: 9.0

    Most recent Super Bowl champion
    Tom Brady confidant
    Whiskey lover and overall life enthusiast
    Arians has transitioned beautifully from life as the quarterback whisperer to life as the ultimate culture creator. His bright, young, diverse coaching staff is talented and something he can leave behind for another decade. His ability, as reported by our own Jenny Vrentas and Greg Bishop, to meld his offense and put his pride aside to accommodate Brady’s wishes brought forth a Super Bowl win that will stand forever.

    TIER 2
    Kyle Shanahan, 49ers
    CSR: 8.8

    Super Bowl appearance
    Creator of the NFL’s most en vogue offense
    Pioneer of meshed-back trucker hat renaissance
    It feels like even if the 49ers miss the playoffs this year there won’t be a ton of pressure on Shanahan, who has shown how dominant of a coach he can be with a fully healthy roster at his disposal. Shanahan’s coaching staff has been routinely pillaged during his time in the NFL, a sign that he’s doing something right.

    Sean McVay, Rams
    CSR: 8.8

    Super Bowl appearance
    Photographic memory
    Potent, option-style quarterback still in his athletic prime
    I feel fairly confident in saying that if the Rams were to shake anything up in the event of a down year in 2021, it would not be with the coaching staff. McVay rode his brilliant scheme to a Super Bowl appearance in 2018 and now gets a quarterback, in Matt Stafford, who can perhaps serve as a better avatar for his system. The future appears bright in L.A. Best of all, McVay’s identification of Brandon Staley shows he can identify coaching talent as well as on-field talent.

    Matt LaFleur, Packers
    • Ascending young offensive play-calling star
    • Can handle being around Aaron Rodgers
    • Former quarterback of a team called the Omaha Beef

    CSR: 8.8

    I view LaFleur on similar footing as Shanahan or McVay, given two straight 13-win seasons and two straight trips to the conference title game. The result in those games, outside of the interesting call to kick a field goal against the Buccaneers, was largely due to inefficiencies out of LaFleur’s control. The Packers struck gold with this hire and there’s little doubt he will be there after Rodgers moves on.

    Sean McDermott, Bills
    CSR: 8.7

    Ignited the league’s wildest fan base
    Changed a broken culture and made the Bills into consistent winners
    Accomplished wrestler, potentially the most dangerous NFL coach in hand-to-hand combat
    Buffalonians fall deeply in love with coaches who can bring even a modicum of energy to their city. Bring them within a whiff of the Super Bowl again and you can feel comfortable buying a house and hanging out for a while. McDermott has assembled one of the league’s best coaching staffs and has an ascending star quarterback still on a rookie deal.

    Ron Rivera, Washington
    CSR: 8.6

    Super Bowl appearance (at a previous stop)
    Defensive mastermind with a talented roster
    Quietly intimidating
    Rivera has brought a level of professionalism to Dan Snyder’s Washington Football Team that we haven’t seen since Mike Shanahan, which either means he can stay as long as he wants, or some absurd organizational discord will force his ouster after one just okay season. In all seriousness, there was a lot of mess to clean up, and Rivera brought a big shovel.

    Mike Vrabel, Titans
    CSR: 8.1

    Consistently fields teams that play well above on-paper expectation
    Fun dad
    Great mustache
    Vrabel has the eye and connections to field good offensive coordinators and the drawing power to bring in legendary defensive help when needed. He connects with players on a deeper level than perhaps any of the other current NFL head coaches and will always be a difficult coach to game plan against. He is the original kneecap biter.

    Mike Zimmer, Vikings
    CSR: 8.1

    Three playoff appearances in six years, 64 total wins
    Ornery, defensive mastermind with a history of good offensive assistants
    Owner of a rustic paradise with the largest deer head of any NFL coach
    Zimmer has become the definition of Why get rid of him? He’s always good enough, his teams are always somewhat competitive, he drafts fairly well and has no major flaws as a head coach. He fits the vibe in Minnesota well and has squeezed some impressive runs out of some O.K. teams.

    Kevin Stefanski, Browns
    CSR: 8.0

    Took the Browns to the playoffs for the first time since Nickelback’s “How You Remind Me” was the No. 1 song in the country
    Piloted a woebegone franchise through a pandemic
    Expertly trimmed 5 p.m. shadow
    Stefanski was the jewel of Browns chief strategy officer Paul DePodesta’s eye for a while, and their first year of marriage alongside GM Andrew Berry proved why. This organization is on the same page and Stefanski’s offense is the perfect fit for Baker Mayfield, who looks more in control and comfortable than at any point in his NFL career. If he can routinely visit the playoffs and develop a long-term quarterback, he’ll have done more than approximately 87 other Browns head coaches have been able to do since 1999.

    Brian Flores, Dolphins
    CSR: 7.9

    Has helped the Dolphins get taken seriously for the first time in more than a decade
    One of the few Belichick assistants who embodies the best of Belichick
    Refused an indirect order to tank and piloted a threadbare roster to five wins
    Flores will be in Miami for a long time, especially if he can find himself an offensive coordinator. His coaching job in 2019 was one of the best efforts from a new head coach we’ve ever seen, single-handedly willing a punchless roster to five wins. If Tua Tagovailoa doesn’t work out, Flores would seem to have the staying power to survive into QB2.

    Frank Reich, Colts
    CSR: 7.0

    • Quarterback whisperer on the rise
    • Two playoff appearances in his first three years
    • Beard/non-Beard versatility

    This will be an interesting season to gauge the long-term future of Reich. Carson Wentz is now (again) his quarterback and the two have an engrained relationship. If the Wentz experiment works, Reich will become indispensable in Indianapolis. If the Colts as presently constructed can’t make the playoffs, thus squandering the team at its collective prime, his star takes a bit of a hit. To be clear, Reich is tracking to be one of the better head coaches in the NFL, but this season could begin to tip the sliding scales in one direction or another.

    Matt Rhule, Panthers
    CSR: 6.8

    Highly sought-after collegiate coach with a history of program turnarounds
    Employer of one of the NFL’s best young offensive coaches
    Has the plucky demeanor of an amalgam of all Friday Night Lights characters
    Rhule’s six-year contract signals staying power on its own, but he handled his first season under the hood pretty well, all things considered. The Panthers were a tough team to play despite having limited talent. His inability to land a big-time quarterback may rear its head at some point, but for now, he’s not going anywhere.

    Joe Judge, Giants
    CSR: 6.9

    Would have coached a rudderless Giants team into the playoffs had the Eagles played four quarters in Week 17
    Has a laundry list of lovable, high school football coach drills
    Emanates grit
    Having covered the Giants on the beat and having covered football in the New York area for a decade, I can tell you there is an immediate smell test that a coach has to pass. Ben McAdoo never passed that test. The same could be said for Pat Shurmur. Joe Judge, on the other hand, seems to have employed a combination of on-field fire, deadpan humor and fundamental knowhow into a comfortable place on the coaching hierarchy.

    TIER 3
    Kliff Kingsbury, Cardinals
    CSR: 6.3

    Air Raid savant
    Tenured relationship with star franchise quarterback
    Impeccable sense of space and decor
    Kingsbury is interesting in that the better Kyler Murray gets (partially because of his tutelage) the more pressure there will be on him to win. Arizona is pushing its chips to the center of the table this offseason, which means all eyes will be on a coach who went 5–10–1 and 8–8 in his first two years. Should he make the playoffs, all is well. Should Arizona falter, can he survive the closer Kyler Murray gets to a new contract?

    Jon Gruden, Raiders
    CSR: 6.2

    Forward thinking offensive mind
    Franchise icon
    Able pitchman
    I believe my former boss Peter King when he says the heat will get dialed up on Gruden if the Raiders don’t make the playoffs this year. Hiring Gruden in grand fashion was a great tribute to Al Davis from his son Mark. But keeping Gruden on a $100 million deal after four seasons and no playoff appearances would be a very un-Al thing to do.

    Mike McCarthy, Cowboys
    CSR: 6.0

    Super Bowl champion (though at a previous stop)
    Known quarterback whisperer
    Expert job interviewer
    I think anyone who’s coaching a quarterback Jerry Jones is paying $40 million per year better make the playoffs. To be clear, I have no doubt McCarthy will turn things around in Dallas, but I have a lot of doubts that Jones would be patient and let a tenured coach take a bunch of time finding his footing while the Cowboys’ core offensive players age out of their prime.

    Matt Nagy, Bears
    CSR: 5.7

    Play design expert
    Two-time playoff participant
    Endearing Philly-Delco accent
    I think Matt Nagy is a gifted painter trying to Bob Ross it in Chicago with a wooden club instead of some brushes. Perhaps Andy Dalton is the answer but, understandably, there isn’t a great deal of enthusiasm going into the season. If I were ownership, I would take solace in the fact that he could get some pretty bare offensive teams to the playoffs. Will ownership actually think that way?

    Vic Fangio, Broncos
    CSR: 5.5

    Creator of the NFL’s most devilish (and frequently copied) defensive scheme
    Experienced coach with strong relationships around the league
    Beloved native of the greater Scranton area
    There isn’t much bad to say about Fangio, but the reality of the situation is that he’s headed into year three of his coaching tenure with no winning seasons and a new general manager on board. This is always a tough situation for a coach, and unless the Broncos turn their fortunes around this year, it might be difficult for him to remain in Denver beyond 2021.

    Zac Taylor, Bengals
    CSR: 5.4

    Highly recommended play-caller from the Sean McVay tree
    Expressed a rare willingness and enthusiasm to live and work in Cincinnati
    Fan of simple, resellable home design
    I don’t know if the Bengals would get rid of Taylor after two years, but in general, life is fairly complicated for a head coach when he gets a quarterback at No. 1. The clock immediately starts ticking, and as good as Joe Burrow looked before his injury, would the Bengals start to worry that they aren’t getting enough out of their investment? Like the Gruden blurb, this is highly dependent on an owner we expect to be non-reactionary to actually be reactionary.

    #128624
    Avatar photoZooey
    Moderator

    Most 5th year qbs can’t read disguised coverages well. If that weren’t true than the Staley defense would have been a bust all along.

    Stafford was not reading disguised defenses well in his 5th year. If through some strange time loop McVay had been coaching a 5th year Stafford, McVay would have made all the same mistakes.

    How do you fix a 5th year qb who has trouble with disguised coverages (the way most 5th year qbs do?) You patiently coach him up as experience begins to shift the tide.

    That is all on McVay. That is the only way I can read all of this–that’s the only thing that adds up and stands up to scrutiny.

    Well, I don’t agree that we can say this is all on McVay.

    I agree that McVay screwed it up. No doubt. But I think there have been several 5th year QBs who read defenses well in their 5th years. Well before that, even. I don’t know anything about Stafford, or his development, but…okay.

    But that doesn’t mean that Goff isn’t a slow learner. It could be that both things are true. Was Goff making the same misreads time and time again? I don’t have any real idea what Goff was doing wrong, or reading wrong, but…sorry…lots of QBs get it before their 5th year, and if they are not showing progress by then, I don’t know what to say. I mean… Goff regressed according to multiple reports.

    In any event, the Rams window to win is right now. 2021 and 2022, maybe. According to McVay, Snead, and a few other people, Stafford gives them a much better shot of doing that.

    If he doesn’t… McVay’s next job will be as OC in Detroit.

    #128622
    Avatar photozn
    Moderator

    Well, we gotta hope McVay is a better learner than Goff.

    Cuz…really, tearing down a young guy like that constantly, and with increasing intensity, is a mistake. Like a “league source” said, you have to build his confidence, and McVay did the opposite of that.

    However, the word is that Goff just couldn’t read some defenses properly,

    Most 5th year qbs can’t read disguised coverages well. If that weren’t true than the Staley defense would have been a bust all along.

    Stafford was not reading disguised defenses well in his 5th year. If through some strange time loop McVay had been coaching a 5th year Stafford, McVay would have made all the same mistakes.

    How do you fix a 5th year qb who has trouble with disguised coverages (the way most 5th year qbs do?) You patiently coach him up as experience begins to shift the tide.

    That is all on McVay. That is the only way I can read all of this–that’s the only thing that adds up and stands up to scrutiny.

    #127175
    Avatar photoInvaderRam
    Moderator

    McVay strikes me as the kind of person that if you jettison him, he comes back stronger with his next team a few years down the road.

    Or the organization can be patient with him while he matures.

    Goffs contract is going to look a lot better in a couple/three years when the cap goes up.

    i agree with all of that. i just don’t like this pitting goff and mcvay against each other.

    i have faith they’ll sort this out. until i see more that is.

    #127173
    Hram
    Participant

    McVay strikes me as the kind of person that if you jettison him, he comes back stronger with his next team a few years down the road.

    Or the organization can be patient with him while he matures.

    Goffs contract is going to look a lot better in a couple/three years when the cap goes up.

    #127164
    Avatar photozn
    Moderator

    i would agree with that. but we don’t know what mcvay is frustrated by

    Or IF he should be frustrated. Maybe he should just be a hard-working, head-down, steady coach. He’s never had to be patient as a head coach, he arrived and took over a talent-stocked team. He never had to build or rebuild. My dark side is wondering how much McVay has to mature and get over some entitlement.

    #127137
    Avatar photoInvaderRam
    Moderator

    The defense made this a fun season for me. Special Teams was broke. imo The offense was ok, if slightly broken. Goff is ok. I am not here to kick him off the bus, but I want a better QB. I know some like him and some hate him. I am in the middle looking for an upgrade.

    defense. amazing. so much fun.

    on goff. he’s average to above average. the green bay game did nothing to dissuade me from that. i listened to the podcasts and analysis of goff’s game, and i pretty much agree. he’s not going to offer the rams anything beyond what he’s already shown. he needs everything around him to be in order. but when it is. he can be real good.

    mcvay is probably wondering to himself if that is something he can live with. but finding an upgrade will be hard. it would be a career defining move for sean if attempts to pull it off. but it won’t be this offseason.

    also. lastly. i liked watching cam akers. i hope he can stay healthy next year. love his running style. patient but explosive. and he’s tough. i hope he sticks around for awhile.

    #125455

    Topic: Covid Penis

    in forum The Public House
    JackPMiller
    Participant

    https://elemental.medium.com/yes-covid-penis-is-a-thing-4a88a3843c2c

    Yes, Covid Penis Is a Thing
    Some men say Covid-19 is hitting them below the belt
    Wudan Yan 12 hours ago

    When Steven Bell caught Covid-19 this spring, he was surprised that he didn’t have a fever. Rather, it felt like a bad sinus infection. Soon, he lost his sense of smell, and went on to develop insomnia. He felt like the virus was also affecting his circulation, and would swing his arms in circles to keep the blood flowing. Then, more bafflingly, when he and his wife were intimate, he couldn’t get an erection. “It was frustrating and infuriating for me, because I knew it wasn’t working the way it should,” said Bell, a 49-year-old from Phoenix, AZ. “My ego wouldn’t accept that I was performing like an 80-year-old in the bedroom.”

    Some men who have survived Covid-19 say that the virus may have impacted their ability to get or maintain an erection. That tracks with the idea that Covid-19 is a vascular disease, which Elemental senior writer Dana Smith explained at length in May, as blood flow is important for getting or maintaining an erection. Erectile dysfunction can occur at any age — and becomes more common as men get older — and may affect up to a third of all men. In the context of Covid-19, men as young as 39 have been documented to experience erectile dysfunction as they recovered from the virus.

    “In order to have really great sex, you have to be able to relax. The pandemic just makes that exceedingly difficult for many people.”

    Currently, there are a handful of anecdotal reports, but no hard data nor large-scale study that documents the link, if any, between Covid-19 and erectile dysfunction. But for the men experiencing such issues, they’re convinced that the erectile dysfunction was caused by the novel coronavirus, because they never had issues with arousal or performance during sex prior to contracting the virus. Hunter Wessells, MD, a urologist at the University of Washington School of Medicine, urges other practitioners to collect this data on their patients. “It’s important to study it, because the total number of people involved may be in the millions and across all age ranges,” he says.

    What’s actually causing the ED?

    Figuring out the cause of erectile dysfunction would be challenging as there are so many potential causes.

    No matter the cause, “[erectile dysfunction is] the final common pathway that no man wants to go to,” says William W. Li, MD, president and medical director of the Angiogenesis Foundation, a nonprofit that studies the health and disease of blood vessels.

    For starters, the pandemic has introduced an immense amount of stress, says Alexandra Stockwell, a relationship and intimacy expert. “The desire for sex and intimacy is lower,” Stockwell says. “In order to have really great sex, you have to be able to relax. The pandemic just makes that exceedingly difficult for many people.”

    That seemed true for Bruce (whose name has been changed to protect his privacy), a 66-year-old from Long Island, NY, who experienced erectile dysfunction after getting Covid-19 in late March. For him, the ED, which persisted for four to five weeks, was just the tip of his issues. “I just wanted to be alive,” he said. “The ED was no big deal.”

    Based on what scientists know about SARS-CoV-2, the virus that causes Covid-19, it’s possible that the virus could have direct effects on erectile dysfunction. Successfully getting and maintaining an erection not only depends on mood, but also testosterone, blood flow, and nerves. In the penis, nerves are critically dependent on a fishnet of blood vessels to get an erection. SARS-CoV-2 exploits the ACE2 receptor, which is found in both nerve cells and endothelial cells lining blood vessels. ACE2 is also found in the cells of the testicles, the organ in men that makes testosterone, a hormone that fuels a man’s sex drive. Li and his colleagues have found that the virus infects testicular cells during the acute phase of Covid-19, which means the virus may be impacting testosterone production.

    On top of the effects in the penis, Covid-19 affects the cardiovascular and pulmonary systems, which, in turn, are critical for sexual function, says Li.

    Wessells notes that underlying health conditions, such as diabetes, obesity, hypertension, inactivity, and smoking, may predispose men to developing ED, and that at least a few of those are associated with a higher risk of contracting Covid-19 as well. Once someone contracts Covid-19, that may be the “straw that broke the camel’s back for the ED,” Wessells says.

    Fortunately, for men who suffer from erectile dysfunction, many treatments, such as Viagra, should help even if Covid-19 has damaged the vasculature, says Wessells.

    Some men who say Covid-19 caused their erectile dysfunction have found some reprieve.

    Art (whose name has also been changed to protect his privacy), a 53-year-old from Elmira, New York, waited until marriage to have sex with his wife. Both of them got Covid-19 in the spring. During their honeymoon this summer, the sex just… didn’t happen, because he couldn’t get an erection. “We knew we wanted children, but I’m having all sorts of issues,” he said. “There’s definitely a degree of guilt. I’m convinced I’m the problem.” Doctors dismissed his concerns that the erectile dysfunction may have been caused by Covid-19. He eventually got over the stigma of talking about his sexual health and opened up to his parents, who suggested he start taking Geritol, vitamins that help with sexual dysfunction. So far, Art says, they’ve helped. “I need to make the best of it when I have it.”

    Even so, the emotional toll for some men persists.

    “When I’m in the mood and physically reporting for duty, my anxiety has increased,” says Bell. And he’s still sometimes frustrated about the impact that Covid-19 has had on his sex life: the erectile dysfunction “crushed” his confidence during sex.

    For now, he hopes that his story offers a cautionary tale. “Stay away from Covid to keep that willy up.”

    #125202
    Avatar photozn
    Moderator

    Week 12: 4 Observations on the L.A. Rams’ 23-20 loss to the 49ers

    * http://ramstalk.net/week12ramsloss/

    The Los Angeles Rams (7-4) suffered a heartbreaking 23-20 loss to the San Francisco 49ers (5-6) at SoFi Stadium on Sunday, November 29. Rams quarterback Jared Goff completed 19 of 31 passes for 198 yards, two interceptions and a fumble lost in the defeat.

    Here are four observations on the game:

    TIME FOR JARED GOFF TO GROW UP

    I’ve defended Goff for much of his career for good reason. The Rams put him in a poor position with former head coach Jeff Fisher as a rookie, and he’s played under multiple offensive coordinators and quarterback coaches. However, the Rams traded a bounty to select him as the No. 1 overall pick of the 2016 NFL Draft to be their franchise quarterback. They later paid him $134 million over four years ($110 million guaranteed) believing that he was ready to lead the franchise. What we saw today from Goff is far below any bar set for a fifth-year franchise quarterback. In truth, Goff’s performance put him nowhere near the value of what the Rams are paying for.

    Goff will enter next week’s game against the Arizona Cardinals with the highest completion percentage of his career (67.25%). He’s already over 3,000 passing yards with an improved touchdown to interception ratio (16-10) over last season. Yet the inconsistent play that began in late 2018 has continued well into this season. Goff struggles under pressure and often fails to read opposing defenses. He possesses elite raw talent, but Goff’s decision-making often hurts his team at the worst times.

    The Rams’ defense led the comeback against the 49ers, saving Goff from taking full responsibility for the team’s loss. Still, his mistakes buried the Rams for much of the game. There are no more excuses for Jared Goff. His offensive line didn’t perform well, and head coach Sean McVay certainly deserves to be questioned for his playcalling, but Goff is paid to lead this franchise on the field. It’s time he acted like it.

    SEAN MCVAY’S FAILURE EVIDENT

    I’ve said it time and time again on the Rams Talk Radio podcast: John Lynch built the 49ers to beat the Rams. However, that doesn’t mean the Rams cannot match up with them. The 49ers feature a strong pass rush and a fast front seven. Defensive coordinator Robert Saleh continually gameplans well for the Rams by constantly pressuring Goff and shutting down the edge against the running game.

    Sean McVay failed to adjust for his offensive line’s rough performance against the 49ers pass rush for much of the first 35 minutes of the game. Keeping Goff in the pocket against that pass rush proved costly time and time again. Couple that with his failure to establish the running game and McVay hamstrung his quarterback. The 49ers’ speed stymied the Rams running game on the outside, so the obvious answer would be to attack that speed by going in between the tackles. Unfortunately, McVay failed to do that until later in the game.

    McVay remains one of the brightest young minds in the game. However, he won’t win a Super Bowl until he learns to get out of his own way. Right now, McVay tends to get impatient when things don’t go his way, especially with the running game. Sometimes it’s a matter of patience, especially when facing athletic defenses. McVay could go down in history as one of the greatest coaches in the NFL. I truly believe that. However, it’s not going to happen if he doesn’t get out of his own head more.

    THE OFFENSIVE LINE IS A CONCERN

    The Rams offensive line protected Goff well against Tampa Bay last week, but it struggled against the aggressive 49ers front seven. Add in the Rams’ issues running the ball in the last two weeks, and there is reason for concern. The unit simply isn’t getting enough push at the line with left tackle Andrew Whitworth out of the lineup. Los Angeles is at its best when it physically controls the game. The Rams aren’t doing that, and with the Arizona Cardinals’ Kyler Murray up next, a power running game is essential for their chances. It’s time for this entire unit to step up both in pass protection and in the running game. The Rams won’t make it far without the big men showing what they are made of up front.

    THE BRIGHT SPOT

    Fortunately, defensive coordinator Brandon Staley’s unit kept the Rams in the game despite four turnovers from the offense. Defensive lineman Aaron Donald reaffirmed his place among the best in the league with a dominant performance in the second half, culminating in a forced fumble returned for a touchdown by defensive back Troy Hill. There will be those that are critical of the defense’s performance on the last drive of the game. Yet it seems idiotic to point the blame at a unit that pulled the Rams back from the brink. The tired defense proved unable to make one more stop, but a nine-minute time of possession difference points to the offense, which failed to carry its weight. If Goff and the offense can figure it out, the Rams have a chance at a deep playoff run.

    #124630

    In reply to: Tampa next…thots?

    Avatar photozn
    Moderator

    Ram_Ruler

    The bucs offense isn’t very patient and tries to force things vertically but the Rams do a good job of taking away the big plays. Bucs bury themselves by not adjusting (see the bears game).

    #124626
    Avatar photozn
    Moderator

    Science Has Learned So Much About COVID—and the Trump Administration Hasn’t Learned Anything at All
    We’ve come a long way since March, yet our leaders are giving up.

    * https://www.motherjones.com/politics/2020/11/science-has-learned-so-much-about-covid-and-the-trump-administration-hasnt-learned-anything-at-all/?utm_campaign=later-linkinbio-motherjonesmag&utm_content=later-12061299&utm_medium=social&utm_source=instagram&fbclid=IwAR0vK6NFHQWS49wak3FxoItjOCV3DXXYSwPDLQzfoT84Nn1jdY7Oitc95kQ

    We are in the throes of the coronavirus’ deadly third surge. Daily cases in the United States are getting dangerously close to 200,000, and a map with each state’s case count basically looks like one big hot spot. New stay-at-home advisories and mask mandates have been issued in some communities in the Midwest. California is putting the brakes on its reopening plans. ICUs are filling up fast. In North Dakota, health care workers who test positive but aren’t showing symptoms are being asked to report to work. Dr. Anthony Fauci recently warned that an additional 200,000 people could die of COVID by the spring if we don’t get things under control soon.

    How did we get to such a dark place? In part, it’s the fault of the cold weather driving people indoors, where the virus spreads much more efficiently. At Mother Jones, we’ve charted the abject failure of the Trump administration to do anything about the spread of the coronavirus—you can see its sweep in our timeline, which is called Superspreader in Chief. We’ve watched in horror as our leaders sat back and let a quarter of a million Americans die, promoting dangerous misinformation. The Great Barrington Declaration, embraced by White House coronavirus adviser Scott Atlas, basically suggests letting the virus run its course—a plan that would lead to millions of unnecessary deaths, mostly in vulnerable communities. For many reasons, it’s looking like Americans are just giving up.

    Our leaders’ attitude of indifference is contagious, and as a result, there’s an all-or-nothing kind of mentality as we go into the holidays: You can hole up in your house alone—or blithely ignore the disease and host a rager with 50 members of your extended family. Indeed, a new Ohio State poll out this week found that 38 percent of people surveyed planned to attend holiday gatherings of 10 or more people.

    When looking around for others to blame, the Trump administration has cast public health officials as the enemies—bloodless, liberal data wonks who want to enforce draconian lockdowns while destroying what’s left of the economy. Nothing could be further from the truth: Scientists are working overtime to figure out how we can reduce our risk so we can continue to live our lives. (If we had an effective public health messaging system, we’d know that, but I digress.)

    Here’s the secret that the Trump administration doesn’t want you to know: Science can set us free. Though the pandemic may seem to be dragging on indefinitely, we’re learning about the coronavirus at an unbelievable clip. Scientists know so much more now than they did back in March about how the virus spreads—and how to stop it in its tracks.

    One of my son’s favorite books is Boy, Were We Wrong About Dinosaurs! It’s all about how paleontologists have revised their hypotheses over the years as they uncover more fossils to learn from. It’s kind of been the same experience for epidemiologists, virologists, and infectious disease experts over these last nine months. Here’s a far from comprehensive list of some of the leaps they’ve made. Let’s call it Boy, Were We Wrong About the Coronavirus!

    Back in March, we thought: that the virus was transmitted on surfaces like doorknobs, counters, and food packaging.

    Now we know: that while the virus can survive on surfaces, it’s mostly transmitted through respiratory droplets from breathing, talking, laughing, singing, coughing, and sneezing.

    What that means: Most public health experts still emphasize the importance of hand-washing and regular surface cleaning, but they don’t recommend wiping down your groceries.

    Back in March, we thought: that masks weren’t effective in preventing the spread of the virus.
    Now we know: that cloth face coverings can protect both the wearer and those around them. One recent University of Washington study estimated that universal mask-wearing could save 130,000 lives by February. Masks may even act as a crude vaccine, exposing wearers to just enough virus to trigger an immune response.

    What that means: You can feel pretty safe running to the grocery store, the doctor’s office, or other public indoor spaces if you and others are wearing masks. You can minimize your risk of transmitting the virus during a holiday gathering if everyone wears masks and stays outside.

    Back in March, we thought: that only people who showed symptoms could transmit the coronavirus.

    Now we know: that asymptomatic people can and do spread the virus.
    What that means: Health care professionals can now tell patients who have been exposed to someone with the virus to isolate right away, even if they don’t feel sick, thereby preventing additional infections.

    Back in March, we thought: that we’d never be able to scale up testing enough to make a difference.

    Now we know: that while we still have a long way to go, testing is free, quick, and readily available in many places. Just this week, there was more good news on the testing front: The FDA has authorized the first at-home rapid test for the virus.

    What that means: We now have the ability to catch cases early, before the infected person has a chance to spread the virus to many others. The key now is convincing people to be tested and investing in systems to warn people who have been in close contact with those who test positive.

    Back in March, we thought: that air filtration systems might not help limit the spread of the virus.

    Now we know: that while they’re not enough on their own to protect us, when used correctly and in combination with masks, HEPA filters can help.
    What that means: Installing filters can offer an additional layer of protection for essential spaces like hospitals and classrooms.

    Back in March, we thought: that schools would be the main way that the coronavirus spreads.

    Now we know: that while school outbreaks do occur, indoor spaces where adults congregate are much more likely to lead to outbreaks. A recent study in the journal Nature found that in urban areas, restaurants, gyms, hotels, cafes, and houses of worship were the source of most superspreader events. Schools, meanwhile, have not seen as many outbreaks as experts initially feared, especially at the elementary level.

    What that means: We can prioritize reopening schools with appropriate safety measures—and putting more restrictions on restaurants, bars, gyms, and other adult-centered businesses.

    To explain the power of these measures, public health experts like to use the analogy of layers of slices of Swiss cheese. In one slice, there are many holes. If you add another slice, it covers up a few of those holes, and so on. The more layers, the closer you get to an opaque hunk of cheese. The more virus-protection strategies you layer on, the less likely it is the virus will sneak through.

    Of course there are more layers should infection occur: Coronavirus treatments have improved immensely—back in March the ventilator was basically the only tool doctors had, and it wasn’t a very good one. Now we know that “proning”—placing patients on their stomach—can help them breathe better. We have a fleet of promising medications, including, as of last week, an antibody treatment that seems to be effective in preventing severe disease. The brass ring, of course, is the promise of several highly effective vaccines expected to begin distribution before year’s end.

    But as I’ve written before, medical breakthroughs on their own won’t stop this virus. What’s more, despite what our leaders say, we don’t have to sit around and wait for a miracle cure, nor must we throw our hands up in despair and let the virus run loose. We do have agency in this situation. We have the power to protect ourselves and our loved ones, thanks to the dazzlingly fast and careful work of scientists. The best way to honor that work is by letting it empower us.

    #124462

    In reply to: Portland anarchy

    waterfield
    Participant

    This following article was on the front page of the L.A. Times this morning under the title “Portland anarchists spark backlash”

    “Portland’s anarchists say they support racial justice. Black activists want nothing to do with them….

    ==================

    I have many layers of thoughts/feelings about ‘anarchist’ direct-action campaigns like this. Too many to list.

    …On the one hand, i think most-if-not-all of the young-anarchists have a higher Political-IQ than 90 percent of the American population. I think they understand what capitalism is doing to the nation, and to the biosphere.
    So, they are smart, informed, passionate, critical-thinkers, for the most part.
    (at least the ones who are legit anarchist, and not proud-boy-types doing false-flag games)

    But, being young, and passionate the anarchists are utterly stupid when it comes to strategy, tactics, etc. Many are impatient, and reckless and selfish. And they are young, so there is no getting thru to them.

    And to just shoot from the hip…I have noticed in my life, that Anarchists tend to be giant pains-in-the-Ass. To everyone. Including other Anarchists.

    Switching to another layer….when i put it in a wider context, Corporate-capitalism is causing mass extinctions, fracking poisoning of children, pollution, Climate Change, Mass Incarceration, Ungodly-Inequality which leads to massive suffering and death, Imperialism, Massive Lie-Campaigns, Coups, Torture, etc etc etc.

    So you have THAT on one hand. Meanwhile the LA Times focuses on a small group of anarchists breaking windows.

    That is corporate media. Perfect example of corporate media. What they cover. How they cover it. And what they dont cover.

    w
    v

    Well-the L.A. Times has published many articles about Portland that run the spectrum. So I don’t subscribe to the notion that they “focus on a small group of anarchists breaking windows”. I also don’t accept the idea that the anarchists were simply breaking windows. I don’t live there and was not there at the time but my childhood and long lasting friend lives outside Portland and said it wasn’t just “windows”. Also my son and his family were visiting Portland after picking up my grandson after a ski camp at Mt. Hood. He said also that it was scary and he is not afraid of broken windows.

    As far as anarchists having a higher IQ than 90% of the US population. That’s simply an outburst. Me? I think most “anarchists” love anarchy. Doesn’t matter what the issue is. They love causing unrest. Not because of political issues. They simply love causing unrest. These are not college post grads going back to coffee houses and discussing Marx and Keynesian economics. No these are simple souls saying “hey look at me. Rage against the machine. You don’t like it-fuck you . Ha,Ha,Ha !” That’s my outburst.

    #124460

    In reply to: Portland anarchy

    Avatar photoZooey
    Moderator

    ==================

    I have many layers of thoughts/feelings about ‘anarchist’ direct-action campaigns like this. Too many to list.

    …On the one hand, i think most-if-not-all of the young-anarchists have a higher Political-IQ than 90 percent of the American population. I think they understand what capitalism is doing to the nation, and to the biosphere.
    So, they are smart, informed, passionate, critical-thinkers, for the most part.
    (at least the ones who are legit anarchist, and not proud-boy-types doing false-flag games)

    But, being young, and passionate the anarchists are utterly stupid when it comes to strategy, tactics, etc. Many are impatient, and reckless and selfish. And they are young, so there is no getting thru to them.

    And to just shoot from the hip…I have noticed in my life, that Anarchists tend to be giant pains-in-the-Ass. To everyone. Including other Anarchists.

    Switching to another layer….when i put it in a wider context, Corporate-capitalism is causing mass extinctions, fracking poisoning of children, pollution, Climate Change, Mass Incarceration, Ungodly-Inequality which leads to massive suffering and death, Imperialism, Massive Lie-Campaigns, Coups, Torture, etc etc etc.

    So you have THAT on one hand. Meanwhile the LA Times focuses on a small group of anarchists breaking windows.

    That is corporate media. Perfect example of corporate media. What they cover. How they cover it. And what they dont cover.

    w
    v

    Yep. ^^^^This^^^^

    #124452

    In reply to: Portland anarchy

    Avatar photowv
    Participant

    This following article was on the front page of the L.A. Times this morning under the title “Portland anarchists spark backlash”

    “Portland’s anarchists say they support racial justice. Black activists want nothing to do with them….

    ==================

    I have many layers of thoughts/feelings about ‘anarchist’ direct-action campaigns like this. Too many to list.

    …On the one hand, i think most-if-not-all of the young-anarchists have a higher Political-IQ than 90 percent of the American population. I think they understand what capitalism is doing to the nation, and to the biosphere.
    So, they are smart, informed, passionate, critical-thinkers, for the most part.
    (at least the ones who are legit anarchist, and not proud-boy-types doing false-flag games)

    But, being young, and passionate the anarchists are utterly stupid when it comes to strategy, tactics, etc. Many are impatient, and reckless and selfish. And they are young, so there is no getting thru to them.

    And to just shoot from the hip…I have noticed in my life, that Anarchists tend to be giant pains-in-the-Ass. To everyone. Including other Anarchists.

    Switching to another layer….when i put it in a wider context, Corporate-capitalism is causing mass extinctions, fracking poisoning of children, pollution, Climate Change, Mass Incarceration, Ungodly-Inequality which leads to massive suffering and death, Imperialism, Massive Lie-Campaigns, Coups, Torture, etc etc etc.

    So you have THAT on one hand. Meanwhile the LA Times focuses on a small group of anarchists breaking windows.

    That is corporate media. Perfect example of corporate media. What they cover. How they cover it. And what they dont cover.

    w
    v

    #124293
    Avatar photozn
    Moderator

    from ‘No One Is Listening to Us’
    More people than ever are hospitalized with COVID-19. Health-care workers can’t go on like this.

    https://www.theatlantic.com/health/archive/2020/11/third-surge-breaking-healthcare-workers/617091/?fbclid=IwAR27_eCSc48uJXsmkaMydzbwbSLSHlRDZmAbvpUss-TEpfW4zpH8hL4yiIo

    Every time nurse Megan Ranney returns to the hospital, there are more COVID-19 patients.

    In the months since March, many Americans have habituated to the horrors of the pandemic. But health-care workers do not have the luxury of looking away: They’re facing a third pandemic surge that is bigger and broader than the previous two. In the U.S., states now report more people in the hospital with COVID-19 than at any other point this year—and 40 percent more than just two weeks ago.

    Emergency rooms are starting to fill again with COVID-19 patients. Utah, where Nathan Hatton is a pulmonary specialist at the University of Utah Hospital, is currently reporting 2,500 confirmed cases a day, roughly four times its summer peak. Hatton says that his intensive-care unit is housing twice as many patients as it normally does. His shifts usually last 12 to 24 hours, but can stretch to 36. “There are times I’ll come in in the morning, see patients, work that night, work all the next day, and then go home,” he told me. I asked him how many such shifts he has had to do. “Too many,” he said.

    Hospitals have put their pandemic plans into action, adding more beds and creating makeshift COVID-19 wards. But in the hardest-hit areas, there are simply not enough doctors, nurses, and other specialists to staff those beds. Some health-care workers told me that COVID-19 patients are the sickest people they’ve ever cared for: They require twice as much attention as a typical intensive-care-unit patient, for three times the normal length of stay. “It was doable over the summer, but now it’s just too much,” says Whitney Neville, a nurse based in Iowa. “Last Monday we had 25 patients waiting in the emergency department. They had been admitted but there was no one to take care of them.” I asked her how much slack the system has left. “There is none,” she said.

    The entire state of Iowa is now out of staffed beds, Eli Perencevich, an infectious-disease doctor at the University of Iowa, told me. Worse is coming. Iowa is accumulating more than 3,600 confirmed cases every day; relative to its population, that’s more than twice the rate Arizona experienced during its summer peak, “when their system was near collapse,” Perencevich said. With only lax policies in place, those cases will continue to rise. Hospitalizations lag behind cases by about two weeks; by Thanksgiving, today’s soaring cases will be overwhelming hospitals that already cannot cope. “The wave hasn’t even crashed down on us yet,” Perencevich said. “It keeps rising and rising, and we’re all running on fear. The health-care system in Iowa is going to collapse, no question.”

    In the imminent future, patients will start to die because there simply aren’t enough people to care for them. Doctors and nurses will burn out. The most precious resource the U.S. health-care system has in the struggle against COVID-19 isn’t some miracle drug. It’s the expertise of its health-care workers—and they are exhausted.

    The struggles of the first two COVID-19 surges in the United States helped hospitals steel themselves for the third. Hardened by the crucible of March and April, New York City built up its ability to spot burgeoning hot spots, trace contacts, and offer places where infected people can isolate. “We’re seeing red flags but we’ve prepared ourselves,” says Syra Madad from NYC Health + Hospitals. Experienced health-care workers are less fearful than they were earlier this year. “We’ve been through this before and we know what we have to do,” says Uché Blackstock, an emergency physician who works in Brooklyn. And with the new generation of rapid tests, Blackstock says she can now tell patients if they have the coronavirus within minutes—a huge improvement over the spring, when tests were scarce and slow.

    Smaller clinics, nursing homes, and long-term-care facilities are still struggling to provide personal protective equipment, including gloves and masks. “About a third are completely out of at least one type of PPE” despite having COVID-19 cases, says Esther Choo, a physician at Oregon Health and Science University and a founder of Get Us PPE. But larger hospitals are doing better, having built up stockpiles and backup plans in case supply chains become strained again. “The hospital is probably the safest place to work in Iowa, because we actually have PPE,” Perencevich said.

    Most important, COVID-19 is no longer a total mystery. Health-care workers now have a clearer idea of what the SARS-CoV-2 coronavirus is capable of. Protocols that didn’t exist in the spring have become habit. “It used to be that to do a single thing, people would start email chains and you’d be 100 emails in before we knew the answer,” Choo says. “Now we’re moving faster. It feels a lot more confident.”

    There are still no cures, and the best drug on offer—the steroid dexamethasone—reduces the odds of dying from COVID-19 by at most 12 percent. But doctors know how to triage patients, which tests to order, and which treatments to use. They know that ventilators can sometimes hurt patients, and that “proning”—flipping patients onto their stomach—can help. They know about the blood clots and kidney problems. They know that hydroxychloroquine doesn’t work. This cumulative knowledge means that death rates from COVID-19 are much lower now than they were in the spring. Flattening the curve worked as intended, giving health-care workers some breathing room to learn how to handle a disease that didn’t even exist this time last year.

    But these hard-earned successes are brittle. If death rates have fallen thanks to increasing medical savvy, they might rise again as nurses and doctors burn out. “If we can get patients into staffed beds, I feel like they’re doing better,” Perencevich said. “But that requires a functional health-care system, and we’re at the point where we aren’t going to have that.”

    Intensive-care units are called that for a reason. A typical patient with a severe case of COVID-19 will have a tube connecting their airways to a ventilator, which must be monitored by a respiratory therapist. If their kidneys shut down, they might be on 24-hour dialysis. Every day, they’ll need to be flipped onto their stomach, and then onto their back again—a process that requires six or seven people. They’ll have several tubes going into their heart and blood vessels, administering eight to 12 drugs—sedatives, pain medications, blood thinners, antibiotics, and more. All of these must be carefully adjusted, sometimes minute to minute, by an ICU nurse. None of these drugs is for treating COVID-19 itself. “That’s just to keep them alive,” Neville, the Iowa nurse, said. An ICU nurse can typically care for two people at a time, but a single COVID-19 patient can consume their full attention. Those patients remain in the ICU for three times the length of the usual stay.

    Nurses and doctors are also falling sick themselves. “The winter is traditionally a very stressful time in health care, and everyone gets taken down at some point,” says Saskia Popescu, an infection preventionist at George Mason University, who is based in Arizona. The third COVID-19 surge has intensified this seasonal cycle, as health-care workers catch the virus, often from outside the hospital. “Our unplanned time off is double what it was last October,” says Allison Suttle of Sanford Health, a health system operating in South Dakota, North Dakota, and Minnesota. Many hospitals have staff on triple backup: While off their shifts, they should expect to get called in if a colleague and their first substitute and the substitute’s substitute are all sick. At least 1,375 U.S. health-care workers have died from COVID-19.

    The first two surges were concentrated in specific parts of the country, so beleaguered hospitals could call for help from states that weren’t besieged. “People were coming to us in our hour of need,” says Madad, from NYC Health + Hospitals, “but now the entire nation is on fire.” No one has reinforcements to send. There are travel nurses who aren’t tied to specific health systems, but the hardest-hit rural hospitals are struggling to attract them away from wealthier, urban centers. “Everyone is tapping into the same pool, and people don’t want to work in Fargo, North Dakota, for the holidays,” Suttle says. North Dakota Governor Doug Burgum recently said that nurses who are positive for COVID-19 but symptom-free can return to work in COVID-19 units. “That’s just a big red flag of just how serious it is,” Suttle says. (The North Dakota Nurses Association has rejected the policy.)

    Short-staffed hospitals could transfer their patients—but to where? “A lot of smaller hospitals don’t have ventilators or staff trained to take care of someone in critical condition,” says Renae Moch, the director of Bismarck-Burleigh Public Health, North Dakota. “They’re looking to larger hospitals,” but those are also full.

    Making matters worse, patients with other medical problems are sicker than usual, several doctors told me. During the earlier surges, hospitals canceled elective surgeries and pulled in doctors from outpatient clinics. People with heart problems, cancers, strokes, and other diseases found it harder to get medical help, and some sat on their illness for fear of contracting COVID-19 at the hospital. Now health-care workers are facing an influx of unusually sick people at a time when COVID-19 has consumed their attention and their facilities. “We’re still catching up on all of that,” says Choo, the Oregon physician. “Even the simplest patients aren’t simple.”

    For many health-care workers, the toll of the pandemic goes beyond physical exhaustion. COVID-19 has eaten away at the emotional core of their work. “To be a nurse, you really have to care about people,” Neville said. But when an ICU is packed with COVID-19 patients, most of whom are likely to die, “to protect yourself, you just shut down. You get to the point when you realize that you’ve become a machine. There’s only so many bags you can zip.”

    As the pandemic moved out of big coastal cities and into rural communities, health-care workers were more likely to treat people they knew personally—relatives, hospital colleagues, the bus driver who drove their kids to school. And across the country, doctors and nurses have struggled with the same anxieties as everyone else—loneliness, extra child-care burdens, the stress of a tumultuous year, fear. “The lines between our personal lives and our careers have completely gone,” says Laolu Fayanju, senior medical director in Ohio of Oak Street Health, a national network of primary-care centers. “We’re often thinking about how we protect ourselves, our families, and our neighborhoods” from the pandemic.

    After SARS hit Toronto in 2003, health-care workers at hospitals that treated SARS patients showed higher levels of burnout and posttraumatic stress up to two years later, compared with those at hospitals in nearby cities that didn’t see the disease. That outbreak lasted just four months. The COVID-19 pandemic is now in its tenth month. “I’ve had conversations with people who’ve been nurses for 25 years, and all of them say the same thing: ‘We’ve never worked in this environment before,’” says Jennifer Gil from Thomas Jefferson University Hospital in Philadelphia, who contracted COVID-19 herself in March. “How much can meditation or mental-health resources help when we’re doing this every day?”

    Even after cases stop climbing, health-care workers will have to catch up on a new round of procedures that didn’t happen because of COVID-19—but without the adrenaline that a packed hospital brings. “Everyone talks about fatigue during the surge, but one of the hardest things is coming down from it,” Popescu says. “You’re exhausted but you still don’t get that mental break.”

    As hard as the work fatigue is, the “societal fatigue” is harder, said Hatton, the Utah pulmonary specialist. He is tired of walking out of an ICU where COVID-19 has killed another patient, and walking into a grocery store where he hears people saying it doesn’t exist. Health-care workers and public-health officials have received threats and abusive messages accusing them of fearmongering. They’ve watched as friends have adopted Donald Trump’s lies about doctors juking the hospitalization numbers to get more money. They’ve pleaded with family members to wear masks and physically distance, lest they end up competing for ICU beds that no longer exist. “Nurses have been the most trusted profession for 18 years in a row, which is now bullshit because no one is listening to us,” Neville said.

    Choo also studies the impacts of health-care policy, and has found that health-care systems sometimes react to imminent policies months before they are actually come into force.

    Still, “you can’t just fix a pandemic this far down the rabbit hole,” Popescu says. “I’m hopeful, but I don’t expect this to suddenly turn itself around overnight.”

    “We can’t just sit on our hands and wait for Jan. 20 to come,” said Megan Ranney, the Rhode Island physician. Several health-care workers I spoke with are trying to keep mild cases of COVID-19 from becoming severe enough to warrant an ICU bed. The Oak Street Health primary-care centers deliver fluids, pulse oximeters, and smart tablets to the homes of newly diagnosed COVID-19 patients, so doctors can check on their symptoms virtually. In North Dakota, South Dakota, and Minnesota, the Sanford Health network has set up outpatient “infusion centers” where elderly COVID-19 patients or those with chronic illnesses can get drugs that might slow the progression of their disease. These drugs will include the antibody therapy bamlanivimab, which received an emergency-use authorization from the FDA on Monday, Suttle told me.

    But the best strategy remains the obvious one: Keep people from getting infected at all. Once again, the fate of the U.S. health-care system depends on the collective action of its citizens. Once again, the nation must flatten the curve. This need not involve a lockdown. We now know that the coronavirus mostly spreads through the air, and does so easily when people spend prolonged periods together in poorly ventilated areas. People can reduce their risk by wearing masks and avoiding indoor spaces such as restaurants, bars, and gyms, where the possibility of transmission is especially high (no matter how often these places clean their surfaces). Thanksgiving and Christmas gatherings, for which several generations will travel around the country for days of close indoor contact and constant conversation, will be risky too.

    Preliminary results suggest that at least one effective vaccine is on the way. The choices made in the coming weeks will influence how many Americans die before they have a chance to receive it, and how many health-care workers are broken in the process.

    #124168
    Avatar photozn
    Moderator

    COVID-19 Hospitalizations Are Surging. Where Are Hospitals Reaching Capacity?
    Surging hospitalizations are straining health care systems around the United States.

    https://www.npr.org/sections/health-shots/2020/11/10/933253317/covid-19-hospitalizations-are-surging-where-are-hospitals-reaching-capacity

    Throughout the U.S., hospitals and health care workers are tracking the skyrocketing number of new coronavirus cases in their communities and bracing for a flood of patients to come in the wake of those infections. Already, seriously ill COVID-19 patients are starting to fill up hospital beds at unsustainable rates.

    U.S. hospitalizations overall have nearly doubled since late September. As of Tuesday, 59,275 COVID-19 patients were hospitalized around the country, nearly on par with the highs of the midsummer and spring surges.

    “We have legitimate reason to be very, very concerned about our health system at a national level,” says Lauren Sauer, an assistant professor of emergency medicine at Johns Hopkins University who studies hospital surge capacity.

    The spring and summer waves of COVID-19 hospitalizations were concentrated largely in a handful of cities in the Northeast and parts of the South.

    With the virus now surging across the country, experts warn that the impact of this next wave of hospitalizations will be even more devastating and protracted.

    “I fear that we’re going to have multiple epicenters,” says Dr. Mahshid Abir, an emergency physician at the University of Michigan and researcher at the Rand Corp. who has developed a model that helps hospitals manage surge capacity.

    If that happens, Abir warns that there won’t be flexibility to shuffle around resources to the places in need because everywhere will be overwhelmed.

    The impact varies state by state with certain areas showing much more rapid increases in hospitalizations. As of Monday, hospitalizations are now rising in 47 states, according to data collected by The COVID Tracking Project, and 22 states are seeing their highest numbers of COVID-19 hospitalizations since the pandemic began.

    Where are hospitals at risk of maxing out?

    With the numbers growing nearly everywhere, the key question for hospital leaders and policymakers is, when is a community on the brink of having more patients than it can handle?

    In parts of the Midwest and the West, hospitals are already brushing up against their capacity to deliver care. Some are struggling to find room for patients, even in large urban hospitals that have more beds.

    But the surge in hospitalizations is not evenly spread — and hospitals’ capacity for weathering case surges varies greatly.

    One way to gauge the growing stress on a health care system is by tracking the share of hospital beds occupied by COVID-19 patients.

    Article continues after sponsor message

    The federal department of Health and Human Services tracks and publishes this data at the state (but not the local) level. Several experts NPR spoke to say that, though imperfect, this is one of the best metrics communities have to work with.

    Though there’s not a fixed threshold that applies to all hospitals, generally speaking, once COVID-19 hospitalizations exceed 10% of all available beds, that signals an increasing risk that the health care system could soon be overwhelmed, explains Sauer.

    “We start to pay attention above 5%,” says Sauer. “Above that, 10% is where we think, ‘Perhaps we have to start enacting surge strategies and crisis standards of care in some places.'”

    Crisis standards of care is a broad term for how to prioritize medical treatment when resources are scarce. In the most extreme cases, that can lead to rationing of care based on a patient’s chance of survival.

    The latest data from HHS shows that in 18 states — mostly in the Midwest — COVID-19 hospitalizations have already climbed above 10%.

    Six states are over 15%, including North Dakota and South Dakota, which are now over 20%.

    Hospital capacity is flexible … until it’s not

    The percentage of hospital beds taken up by COVID-19 patients does not tell a complete story about hospital capacity, says Sauer, but it’s a starting point.

    Hospital capacity is not so much a static number, but an ever-shifting balance of resources. “It’s space, staff and stuff, and you need all three, and if you don’t have one, it doesn’t matter if you have the other two,” says Abir.

    The level of COVID-19 hospitalizations that would be a crisis in one place might not be in another. Still, a growing share of beds occupied by COVID-19 patients can be a strong signal that the health care system is headed for trouble.

    COVID-19 patients can be more labor intensive because health care workers have to follow intricate protocols around personal protective equipment and infection control. And some of the patients take up ICU space.

    “When the numbers go up like that, particularly for critical care, that strains the system pretty significantly,” says Abir. “This is a scarce resource. Critical care nurses are scarce. Ventilators are scarce. Respiratory therapists are scarce.”

    In Utah, where the share of hospitalized COVID-19 patients is about 8%, state health officials have already warned that hospitals may soon be forced to ration care because of limited ICU space.

    There is no “magic number” to indicate when a health care system may be overwhelmed, says Eugene Litvak, who is CEO of the Institute for Healthcare Optimization and helps advise hospitals on how to manage their capacity. But hospitals must be alert to rapid increases in patient load.

    “Even a 10% increase can be quite dangerous,” says Litvak. “If you are a hospital that’s half empty, you can tolerate it.” But U.S. hospitals generally run close to capacity, Litvak says, with above 90% of beds already full — especially toward the end of the week.

    “Imagine that 10% of extremely sick patients on top of that,” he says. “What are your options? You can not admit ambulances and patients with non-COVID medical needs, or you have to cancel your elective surgeries.”

    In the spring, some states ordered that most elective surgeries come to a halt so that hospitals had room for COVID-19 patients, but Litvak says this leads to all kinds of collateral damage because patients don’t get the care they need and hospitals lose money and lay off staff.

    State data may miss local hot spots

    Statewide COVID-19 hospitalization metrics mask huge variations within a state. Certain health care systems or metro areas may be in crisis.

    “It’s very valuable information, but a state average can be misleading,” says Ali Mokdad with the Institute for Health Metrics and Evaluation at the University of Washington, which projects that many states will face big problems with hospital capacity this winter. “It doesn’t tell you where in the states it’s happening.”

    Big urban centers may be much better equipped to absorb a rush of patients than smaller towns.

    In New York City, Mount Sinai Health System was able to more than double its bed capacity during the spring surge. Other communities don’t have the ability to ramp up capacity so quickly.

    “Especially the states that don’t have major cities with major hospitals, you see a lot of stress on them,” Mokdad says.

    But it’s hard for researchers and health leaders to get a clear picture of what’s happening regionally without good data, he adds. NPR has reported that the federal government does not share this local data, although it does collect it daily.

    Some states publish their own hospital data sets. Texas, which shares the data in detail, provides a striking example. Statewide, COVID-19 hospitalizations have reached about 11%. Meanwhile, El Paso is above 40%, which has pushed the health care system to the brink.

    Ultimately, it’s difficult to know the true capacity for a region because many hospitals still don’t coordinate well, says Dr. Christina Cutter, an emergency physician at the University of Michigan who collaborated on the Rand model with Abir.

    “It’s really hard to make sure you’re leveraging all the resources and that one hospital is not overburdened compared to another hospital, and that may have unintended loss of life as a consequence,” Cutter says.

    Dire consequences of overfilled hospitals

    During the height of Arizona’s summer surge, COVID-19 patients filled nearly half of all beds in the state.

    “When 50% of our hospital is doing COVID, it means the hospital is overloaded. It means that other services in that hospital are being delayed,” says Mokdad. “The hospital becomes a nightmare.”

    Health care workers are pushed to their limits and are required to treat more patients at the same time. Hospitals can construct makeshift field hospitals to add to their capacity, but those can be logistically challenging and still require health care workers to staff the beds.

    In Wisconsin, COVID-19 patients account for 17% of all hospitalizations, and many hospitals are warning that they are at or near capacity.

    The Marshfield Clinic Health System, which runs nine hospitals in primarily rural parts of the state, is expecting its share of COVID-19 patients to double, if not more, by the end of the month.

    “That will push us well beyond our staffing levels,” says Dr. William Melms, chief medical officer at Marshfield. “We can always make more space, but creating the manpower to take care of our patients is the dilemma.”

    During earlier surges, many hospitals relied on bringing in hundreds or even thousands of out-of-state health care workers for backup, but Melms says that is not happening this time.

    “We are on an island out here,” he says.

    An increase in COVID-19 hospitalizations statewide is also associated with higher mortality, according to a recent study that analyzed the relationship between COVID-19 hospitalizations and deaths.

    “It’s an indicator that you’re going to have more deaths from COVID as you see the numbers inch up in the hospital,” says Pinar Karaca-Mandic, professor and academic director of the Medical Industry Leadership Institute at the University of Minnesota.

    Specifically, Karaca-Mandic’s research found that a 1% increase of COVID-19 patients in a state’s ICU beds will lead to about 2.8 additional deaths in the next seven days.

    She says a statewide level of 20% COVID-19 hospitalizations may not look all that alarming, but that number doesn’t capture the constraints on the health care system in adding more ICU beds.

    “That’s not very flexible,” she says. “It requires a lot of planning. It requires a lot of investments. So the more you fill up the ICU, the impact is going to be larger.”

    #124085
    Avatar photoBilly_T
    Participant
    #123878

    In reply to: Election Day(s)

    Avatar photoZooey
    Moderator

    https://www.dailyposter.com/p/six-takeaways-from-election-night

    Six Takeaways From Election Night
    Dems’ weak economic message helped Trump, the Lincoln Project embarrassed itself, and a ton of grassroots money was set on fire.

    David Sirota, Andrew Perez, and Julia Rock
    Nov 3

    As the country awaits the final results of the presidential election, there are already six key lessons to be gleaned from election, campaign finance and public opinion data.

    1. Democrats’ Weak Economic Message Hugely Helped Trump
    The Democratic ticket pretty much ran away from economic issues — sure, it had decent position papers, but economic transformation was not a huge part of its public messaging, and that failure buoyed Trump, according to exit polls from Edison Research.

    Trump won 81 percent of the vote among the third of the electorate that listed the economy as its top priority. Even more amazing — Trump and Biden equally split the vote among those whose priority is a president who “cares about people like me.”

    2. The Lincoln Project And Rahm Emanuel Embarrassed Themselves
    The Lincoln Project, the anti-Trump cash cow for veteran Republican consultants, has raised $40 million from MSNBC-watching Brunch Liberals in just the last few months, and is now set to launch a media brand off the idea that its GOP operatives are political geniuses.

    Their ads focused on trying to court disaffected Republican voters and attack Trump’s character, as Biden loaded up the Democratic convention with GOP speakers. When polls during the summer showed that the strategy wasn’t working, galaxy brain Rahm Emanuel defended it to a national televised audience, insisting that 2020 would be “the year of the Biden Republican.”

    Now survey data show the strategy epically failed, as Trump actually garnered even more support from GOP voters than in 2016. Indeed, Edison Research exit polls on Tuesday found that 93 percent of Republican voters supported Trump — three percentage points higher than in 2016, according to numbers from the same firm.

    The takeaway: There may be a lot of so-called “Never Trump Republicans” promoted in the media and in politics, but “Never Trump Republicans” are not a statistically significant group of voters anywhere in America. They basically do not exist anywhere outside of the Washington Beltway or cable news green rooms — and after tonight’s results, we shouldn’t have to see them on TV or even see their tweets ever again.

    As for the Lincoln Project’s focus on trying to scandalize Trump’s character, the exit polls found that voters are far more concerned about policy issues than personality. Seventy-three percent of voters said their candidate’s positions on the issues were more important in their vote for president than their candidate’s personal qualities.

    3. People Don’t Love The Affordable Care Act
    While it may have made short-term sense for Democrats to focus on the GOP’s efforts to repeal protections for patients with pre-existing conditions, Americans actually aren’t particularly pleased with the Affordable Care Act at a moment when millions have lost health insurance and insurers’ profits are skyrocketing because people can’t or don’t want to go to the doctor.

    Edison Research exit polls found that 52 percent of voters think the Supreme Court should keep Obamacare, while 43 percent said the court should overturn it.

    A Fox News Voter Analysis survey, which went to more than 29,000 people in all 50 states between Oct. 26 and Nov. 3, found similar numbers but suggests the ACA’s support is fairly thin: 14 percent of people want to leave the law as is while 40 percent of people would like to improve it.

    The same poll asked voters if they would support changing the health care system so that any American can buy into a government-run health care plan if they want to — also known as a public health insurance option — and found that 71 percent of people support the idea and only 29 percent oppose.

    Although Biden and Senate Democrats both supported a public health insurance option plan, their campaigns and outside spending groups spent more time messaging around protecting the ACA. The Kaiser Family Foundation’s tracking poll has shown consistently middling support for the ACA — and showed that during the summer COVID burst, the law was underwater among Americans aged 50-64.

    The ACA’s protections for patients with pre-existing conditions was a key topic in recent weeks in the lead-up to new Trump Supreme Court Justice Amy Coney Barrett’s confirmation, with the court set to hear a challenge to the law soon.

    In a speech that Biden gave from Wilmington on Oct. 28, focused on COVID-19 and his health care plan, Biden spoke about the importance of trusting science and mask wearing, and highlighted Trump’s attacks on the ACA, but he only mentioned a public option once.

    4. A Lot Of Grassroots Money Was Set On Fire
    Democrats raised roughly a quarter billion dollars for senate races in Kentucky, South Carolina, Texas and Alabama — and their candidates all appear to have gone down to defeat by 10 points or more.

    These are tough states for Democrats, but there’s a cautionary tale about resource allocation among Democrats’ donor base. While grassroots-funded advocacy and media organizations are starved for resources, a handful of candidates can snap their fingers and be awash in cash at election time — and still get crushed.

    Democratic Senate candidates saw a massive surge in donations after Justice Ruth Bader Ginsburg’s death in September — before the party barely put up a fight and Justice Amy Coney Barrett was quickly confirmed to the Supreme Court.

    5. Democrats’ Court Calculation Was Wrong
    When Trump nominated right-wing extremist Amy Coney Barrett to the Supreme Court, the conventional wisdom was that Democrats shouldn’t seriously combat the nomination, because a court fight would primarily motivate conservative voters. Exit polls prove that false: 60 percent of voters said the court was a significant factor in their vote, and a majority of those voters supported Biden — who barely spoke up against the nomination. Had there been a more intense fight, it might have helped the Democrats.

    All but one of the top tier Democratic Senate candidates shied away from talk of adding new Supreme Court court seats if their party won control of the Senate — which doesn’t matter now, since many of them lost anyway.

    6. A Large Percentage Of Americans Have Lost Their Minds
    In mid-October, Bloomberg News reported that “the proportion of Americans dying from coronavirus infections is the highest in the developed world” — and yet exit polls show 48 percent of Americans believe their government’s efforts to contain the coronavirus pandemic are going very well or somewhat well.

    After a season of destructive wildfires and hurricanes, the same exit polls show 30 percent of Americans say climate change is not a serious problem.

    #122661
    Mackeyser
    Moderator

    https://www.usatoday.com/story/sports/nfl/titans/2020/10/08/tennessee-titans-buffalo-bills-game-postponed-covid-19-coronavirus/5922306002/
    Why the NFL needs to immediately end the Titans’ 2020 season
    Since last week, the NFL and NFLPA have had representatives in Nashville, investigating why the Tennessee Titans have by far the most positive COVID tests of any NFL team. The organization has had …
    touchdownwire.usatoday.com

    The Titans’ season should be cancelled. Part of the reason guys like A’Shawn aren’t coming back is because of the positive tests. The rest of the NFL has done amazing.

    View: https://elemental.medium.com/a-supercomputer-analyzed-covid-19-and-an-interesting-new-theory-has-emerged-31cb8eba9d63

    Earlier this summer, the Summit supercomputer at Oak Ridge National Lab in Tennessee set about crunching data on more than 40,000 genes from 17,000 genetic samples in an effort to better understand Covid-19. Summit is the second-fastest computer in the world, but the process — which involved analyzing 2.5 billion genetic combinations — still took more than a week.

    When Summit was done, researchers analyzed the results. It was, in the words of Dr. Daniel Jacobson, lead researcher and chief scientist for computational systems biology at Oak Ridge, a “eureka moment.” The computer had revealed a new theory about how Covid-19 impacts the body: the bradykinin hypothesis. The hypothesis provides a model that explains many aspects of Covid-19, including some of its most bizarre symptoms. It also suggests 10-plus potential treatments, many of which are already FDA approved. Jacobson’s group published their results in a paper in the journal eLife in early July.

    According to the team’s findings, a Covid-19 infection generally begins when the virus enters the body through ACE2 receptors in the nose, (The receptors, which the virus is known to target, are abundant there.) The virus then proceeds through the body, entering cells in other places where ACE2 is also present: the intestines, kidneys, and heart. This likely accounts for at least some of the disease’s cardiac and GI symptoms.

    (Sign up for Your Coronavirus Update, a biweekly newsletter with the latest news, expert advice, and analysis to keep you safe)

    But once Covid-19 has established itself in the body, things start to get really interesting. According to Jacobson’s group, the data Summit analyzed shows that Covid-19 isn’t content to simply infect cells that already express lots of ACE2 receptors. Instead, it actively hijacks the body’s own systems, tricking it into upregulating ACE2 receptors in places where they’re usually expressed at low or medium levels, including the lungs.

    In this sense, Covid-19 is like a burglar who slips in your unlocked second-floor window and starts to ransack your house. Once inside, though, they don’t just take your stuff — they also throw open all your doors and windows so their accomplices can rush in and help pillage more efficiently.

    The renin–angiotensin system (RAS) controls many aspects of the circulatory system, including the body’s levels of a chemical called bradykinin, which normally helps to regulate blood pressure. According to the team’s analysis, when the virus tweaks the RAS, it causes the body’s mechanisms for regulating bradykinin to go haywire. Bradykinin receptors are resensitized, and the body also stops effectively breaking down bradykinin. (ACE normally degrades bradykinin, but when the virus downregulates it, it can’t do this as effectively.)

    The end result, the researchers say, is to release a bradykinin storm — a massive, runaway buildup of bradykinin in the body. According to the bradykinin hypothesis, it’s this storm that is ultimately responsible for many of Covid-19’s deadly effects. Jacobson’s team says in their paper that “the pathology of Covid-19 is likely the result of Bradykinin Storms rather than cytokine storms,” which had been previously identified in Covid-19 patients, but that “the two may be intricately linked.” Other papers had previously identified bradykinin storms as a possible cause of Covid-19’s pathologies.

    Covid-19 is like a burglar who slips in your unlocked second-floor window and starts to ransack your house.

    As bradykinin builds up in the body, it dramatically increases vascular permeability. In short, it makes your blood vessels leaky. This aligns with recent clinical data, which increasingly views Covid-19 primarily as a vascular disease, rather than a respiratory one. But Covid-19 still has a massive effect on the lungs. As blood vessels start to leak due to a bradykinin storm, the researchers say, the lungs can fill with fluid. Immune cells also leak out into the lungs, Jacobson’s team found, causing inflammation.

    Coronavirus May Be a Blood Vessel Disease, Which Explains Everything
    Many of the infection’s bizarre symptoms have one thing in common
    elemental.medium.com

    And Covid-19 has another especially insidious trick. Through another pathway, the team’s data shows, it increases production of hyaluronic acid (HLA) in the lungs. HLA is often used in soaps and lotions for its ability to absorb more than 1,000 times its weight in fluid. When it combines with fluid leaking into the lungs, the results are disastrous: It forms a hydrogel, which can fill the lungs in some patients. According to Jacobson, once this happens, “it’s like trying to breathe through Jell-O.”

    This may explain why ventilators have proven less effective in treating advanced Covid-19 than doctors originally expected, based on experiences with other viruses. “It reaches a point where regardless of how much oxygen you pump in, it doesn’t matter, because the alveoli in the lungs are filled with this hydrogel,” Jacobson says. “The lungs become like a water balloon.” Patients can suffocate even while receiving full breathing support.

    The bradykinin hypothesis also extends to many of Covid-19’s effects on the heart. About one in five hospitalized Covid-19 patients have damage to their hearts, even if they never had cardiac issues before. Some of this is likely due to the virus infecting the heart directly through its ACE2 receptors. But the RAS also controls aspects of cardiac contractions and blood pressure. According to the researchers, bradykinin storms could create arrhythmias and low blood pressure, which are often seen in Covid-19 patients.

    The bradykinin hypothesis also accounts for Covid-19’s neurological effects, which are some of the most surprising and concerning elements of the disease. These symptoms (which include dizziness, seizures, delirium, and stroke) are present in as many as half of hospitalized Covid-19 patients. According to Jacobson and his team, MRI studies in France revealed that many Covid-19 patients have evidence of leaky blood vessels in their brains.

    Bradykinin — especially at high doses — can also lead to a breakdown of the blood-brain barrier. Under normal circumstances, this barrier acts as a filter between your brain and the rest of your circulatory system. It lets in the nutrients and small molecules that the brain needs to function, while keeping out toxins and pathogens and keeping the brain’s internal environment tightly regulated.

    If bradykinin storms cause the blood-brain barrier to break down, this could allow harmful cells and compounds into the brain, leading to inflammation, potential brain damage, and many of the neurological symptoms Covid-19 patients experience. Jacobson told me, “It is a reasonable hypothesis that many of the neurological symptoms in Covid-19 could be due to an excess of bradykinin. It has been reported that bradykinin would indeed be likely to increase the permeability of the blood-brain barrier. In addition, similar neurological symptoms have been observed in other diseases that result from an excess of bradykinin.”

    Increased bradykinin levels could also account for other common Covid-19 symptoms. ACE inhibitors — a class of drugs used to treat high blood pressure — have a similar effect on the RAS system as Covid-19, increasing bradykinin levels. In fact, Jacobson and his team note in their paper that “the virus… acts pharmacologically as an ACE inhibitor” — almost directly mirroring the actions of these drugs.

    Medium Coronavirus Blog
    A real-time resource for Covid-19 news, advice, and commentary.
    coronavirus.medium.com

    By acting like a natural ACE inhibitor, Covid-19 may be causing the same effects that hypertensive patients sometimes get when they take blood pressure–lowering drugs. ACE inhibitors are known to cause a dry cough and fatigue, two textbook symptoms of Covid-19. And they can potentially increase blood potassium levels, which has also been observed in Covid-19 patients. The similarities between ACE inhibitor side effects and Covid-19 symptoms strengthen the bradykinin hypothesis, the researchers say.

    ACE inhibitors are also known to cause a loss of taste and smell. Jacobson stresses, though, that this symptom is more likely due to the virus “affecting the cells surrounding olfactory nerve cells” than the direct effects of bradykinin.

    Though still an emerging theory, the bradykinin hypothesis explains several other of Covid-19’s seemingly bizarre symptoms. Jacobson and his team speculate that leaky vasculature caused by bradykinin storms could be responsible for “Covid toes,” a condition involving swollen, bruised toes that some Covid-19 patients experience. Bradykinin can also mess with the thyroid gland, which could produce the thyroid symptoms recently observed in some patients.

    The bradykinin hypothesis could also explain some of the broader demographic patterns of the disease’s spread. The researchers note that some aspects of the RAS system are sex-linked, with proteins for several receptors (such as one called TMSB4X) located on the X chromosome. This means that “women… would have twice the levels of this protein than men,” a result borne out by the researchers’ data. In their paper, Jacobson’s team concludes that this “could explain the lower incidence of Covid-19 induced mortality in women.” A genetic quirk of the RAS could be giving women extra protection against the disease.

    The bradykinin hypothesis provides a model that “contributes to a better understanding of Covid-19” and “adds novelty to the existing literature,” according to scientists Frank van de Veerdonk, Jos WM van der Meer, and Roger Little, who peer-reviewed the team’s paper. It predicts nearly all the disease’s symptoms, even ones (like bruises on the toes) that at first appear random, and further suggests new treatments for the disease.

    As Jacobson and team point out, several drugs target aspects of the RAS and are already FDA approved to treat other conditions. They could arguably be applied to treating Covid-19 as well. Several, like danazol, stanozolol, and ecallantide, reduce bradykinin production and could potentially stop a deadly bradykinin storm. Others, like icatibant, reduce bradykinin signaling and could blunt its effects once it’s already in the body.

    Interestingly, Jacobson’s team also suggests vitamin D as a potentially useful Covid-19 drug. The vitamin is involved in the RAS system and could prove helpful by reducing levels of another compound, known as REN. Again, this could stop potentially deadly bradykinin storms from forming. The researchers note that vitamin D has already been shown to help those with Covid-19. The vitamin is readily available over the counter, and around 20% of the population is deficient. If indeed the vitamin proves effective at reducing the severity of bradykinin storms, it could be an easy, relatively safe way to reduce the severity of the virus.

    Other compounds could treat symptoms associated with bradykinin storms. Hymecromone, for example, could reduce hyaluronic acid levels, potentially stopping deadly hydrogels from forming in the lungs. And timbetasin could mimic the mechanism that the researchers believe protects women from more severe Covid-19 infections. All of these potential treatments are speculative, of course, and would need to be studied in a rigorous, controlled environment before their effectiveness could be determined and they could be used more broadly.

    Covid-19 stands out for both the scale of its global impact and the apparent randomness of its many symptoms. Physicians have struggled to understand the disease and come up with a unified theory for how it works. Though as of yet unproven, the bradykinin hypothesis provides such a theory. And like all good hypotheses, it also provides specific, testable predictions — in this case, actual drugs that could provide relief to real patients.

    The researchers are quick to point out that “the testing of any of these pharmaceutical interventions should be done in well-designed clinical trials.” As to the next step in the process, Jacobson is clear: “We have to get this message out.” His team’s finding won’t cure Covid-19. But if the treatments it points to pan out in the clinic, interventions guided by the bradykinin hypothesis could greatly reduce patients’ suffering — and potentially save lives.

    NOTE: This article is pretty dense. I’m happy to answer any questions as best I can or make the appropriate referrals.

    If these findings are verified, then it proves WHY athletes who make their living being the best by fractions of a percent are in danger of losing their careers and worse for those with undiagnosed CTE. Even the idea that some player with undiagnosed CTE could get COVID from a careless Titan and have his brain devastated is beyond the pale.

    I agree that the Titans should be harshly dealt with up to and including going straight to ownership and letting them know that this is a forced sale level violation if they don’t take every drastic and immediate measure to get into and stay in compliance with all local, state, federal and league rules.

    Wrt COVID19, the NFL needs to be the Not Fuckin-around League.

    2020 has sucked enough. We don’t need losing football to be the shit cherry on the top of this giant shit sundae of a year…

    • This topic was modified 4 years, 8 months ago by Mackeyser.

    Sports is the crucible of human virtue. The distillate remains are human vice.

    #122556
    Avatar photoBilly_T
    Participant

    You’re just being modest. I’ve always seen you as pretty good at that sort of thing, WV. Patient, almost tireless, and able to communicate with pretty much anyone. You’re a very good spokes-dude for the left.

    I have my good days too, but I suspect they’re far rarer than yours, and my bull in a china shop moods hit me too often.

    Lately, I’ve been discussing these things with family, too, with some recent, surprising advances, but mostly mixed results. I still have a ton to learn.

    As always, thanks to you and others here for recs on this or that writer/thinker/activist, etc.

    =================

    Well, I dunno. I think maybe all the Propaganda-Induced-Ignorance has just taken a toll over the years. But more than that, i guess, is I just KNOW how all the conversations are gonna go. I know how people are going to respond. I can play all the parts. I do not experience anyone changing anyone’s mind. So, what is the point?

    Like many many many leftists, who got old, and burned out, i have basically turned to Nature. Quiet, soothing, peaceful Nature.

    w
    v

    Thanks for the vid. Will take a look.

    Nature. At the risk of sounding grandiose, that’s where I should have made my home. That’s what the plan was, in a sense, after my first go-round with college. Be a painter of nature. Paint abstractions. Make it new. Make it surreal. Write poetry to go with those paintings, and survive on that. But it wasn’t to be.

    I still write poems, but disabused myself of the idea of major recognition, if not renown, via those poems or paintings. But, yeah, being a leftist? Makes that retreat necessary again.

    In Fromm’s book, he talks about the difference between a poem by Tennyson and one by Basho.

    Tennyson:

    Flower in a crannied wall,
    I pluck you out of the
    crannies,
    I hold you here, root and all
    in my hand,
    Little flower — but if I could
    understand
    What you are, root and all,
    and all in all,
    I should know what God
    and man is.

    __

    Basho’s, in English translation:

    When I look carefully
    I see the nazuna blooming
    By the hedge!

    Fromm notes the two poems hold very different visions. Tennyson wants to possess nature, knowing he’ll have to kill that part of Her to do it. Basho, on the other hand, wants to really “see” Her. Leave her intact.

    Being versus owning. Becoming versus having, possession, property, etc.

    It was a catastrophe when humans removed the divine from nature and placed a god above it all, transcendent, instead of immanent. Stripping her of the Sacred, offloading all of that into the being of the former volcano god, Yahweh, was the beginning of the end of Planet Earth.

    • This reply was modified 4 years, 8 months ago by Avatar photoBilly_T.
    #122552
    Avatar photowv
    Participant

    You’re just being modest. I’ve always seen you as pretty good at that sort of thing, WV. Patient, almost tireless, and able to communicate with pretty much anyone. You’re a very good spokes-dude for the left.

    I have my good days too, but I suspect they’re far rarer than yours, and my bull in a china shop moods hit me too often.

    Lately, I’ve been discussing these things with family, too, with some recent, surprising advances, but mostly mixed results. I still have a ton to learn.

    As always, thanks to you and others here for recs on this or that writer/thinker/activist, etc.

    =================

    Well, I dunno. I think maybe all the Propaganda-Induced-Ignorance has just taken a toll over the years. But more than that, i guess, is I just KNOW how all the conversations are gonna go. I know how people are going to respond. I can play all the parts. I do not experience anyone changing anyone’s mind. So, what is the point?

    Like many many many leftists, who got old, and burned out, i have basically turned to Nature. Quiet, soothing, peaceful Nature.

    w
    v

    #122549
    Avatar photoBilly_T
    Participant

    <
    My answer is never to tell people they are “wrong”. But to ask them questions-much like taking a deposition. If one says science doesn’t know everything-my question is “why do you say that”. Then they will say something like “I had a friend who…” Then I ask “do you personally know of others”. At some point the message comes across without them feeling they are looked down upon by someone who comes off as “having all the answers”. Might and likely won’t change their opinions but might give them a pause to think a second time about an issue. “Why do you ” are three very powerful words.

    =================

    OK, but at what point do you usually pull out an ice-pick and run it through their walnut-brain? Because i find that its best to do it just after I’ve asked them an ‘I have a friend’ question.

    w
    v

    You’re just being modest. I’ve always seen you as pretty good at that sort of thing, WV. Patient, almost tireless, and able to communicate with pretty much anyone. You’re a very good spokes-dude for the left.

    I have my good days too, but I suspect they’re far rarer than yours, and my bull in a china shop moods hit me too often.

    Lately, I’ve been discussing these things with family, too, with some recent, surprising advances, but mostly mixed results. I still have a ton to learn.

    As always, thanks to you and others here for recs on this or that writer/thinker/activist, etc.

    #122256

    In reply to: The Big News

    Avatar photoZooey
    Moderator

    https://www.newyorker.com/science/medical-dispatch/how-to-understand-trumps-evolving-condition

    How to Understand Trump’s Evolving Condition
    Day to day, the news can be confusing. But the treatment of COVID-19 has steps, phases, and milestones that can tell us a lot about how the President is doing.
    By Dhruv Khullar

    October 4, 2020

    The days since Donald Trump tested positive for the coronavirus have been more confusing than usual. Consider this exchange from Saturday’s news conference with Sean Conley, the White House physician:

    reporter: Has he also experienced difficulty breathing?

    conley: No, no, he has not. Never did. He had a little cough. He had the fever. More than anything he’s felt run-down.

    A seemingly straightforward answer. And yet later it emerged that Trump’s oxygen levels had already dipped low enough to warrant supplementary oxygen. Was the President not short of breath when that happened? No one who wasn’t there can say for sure, because the Administration hasn’t been communicating clearly and in a detailed way about Trump’s illness. If the President had a fever, then what was his temperature? Has he sustained any lung damage? When did he last test negative for the virus? One might have hoped that Conley, having been roundly criticized for his evasiveness after his first briefing, would be more forthright at his second, on Sunday. Instead, he dodged again. When asked if Trump had received a second round of supplementary oxygen, he pleaded ignorance: “I’d have to check with the nursing staff,” he said.

    The vagueness of the communications we’ve received so far may be intentional: in particular, the question of when and how the President was first diagnosed has become freighted with clinical, epidemiological, and ethical implications. Most reports have placed his first positive test sometime between Wednesday morning and Thursday evening. Clinically, knowing the precise time line would tell us how far into the illness Trump has progressed, and when he will enter the window, usually beginning about a week after the onset of symptoms, in which he’s at the greatest risk for deterioration. Epidemiologically, the timing matters for the many people Trump may have exposed to the virus: the President held campaign events throughout the week, including a fund-raiser in New Jersey on Thursday where he met with dozens of donors—an event that featured a buffet. And, ethically, it affects our judgment of his actions. It’s possible that Trump knew that he had been exposed to the virus, or had even received a diagnosis himself, and yet continued to meet with staff and donors, consciously placing their health at risk.

    These possibilities may be adding to the Administration’s caginess. In any event, the coronavirus is already confusing. In the months since the pandemic started, I’ve cared for scores of patients with covid-19, many of whom, like Trump, have been advanced in age. Doctors speak of the “course” of a disease; my patients’ disease courses have been unpredictable, with long plateaus interrupted by sudden reversals. Now that Trump himself has covid-19, the country as a whole faces the diagnostic challenge with which doctors like me have grown familiar. We must figure out where Trump is in the landscape of clinical possibility and try to guess where he’s headed. In a sense, our task is harder: we must do it without an organized, comprehensive overview of what’s happening, piecing together the scattered information as it emerges.

    Doctors now recognize two broad and somewhat overlapping phases of covid-19. In the first phase, it’s the replication of the virus that causes problems, such as shortness of breath; especially in the lungs, the virus has hijacked the body’s cells to multiply exponentially, and the immune system is fighting to tamp it down. It’s during this phase that antiviral drugs are thought to have their greatest effect; they are like reinforcements for the immune system, and they help to slow the replication of the virus. In the second phase, it’s the immune system itself that starts to become a problem. The virus provokes an immunological storm that wreaks havoc on many organs; the lungs are still at the center of the disease, but other systems get damaged, too. The body must now fight the virus while weathering its own overreaction. Most patients never enter this second, more dangerous phase, but those who do can grow seriously ill.

    To evaluate patients with covid-19, therefore, one must start by determining where in the process they find themselves: are they in the first phase, the second, or the transition between? It’s not unusual for people to be admitted to the hospital during the first phase. Because their lungs are under attack, they often have trouble breathing and need some supportive oxygen; in many cases, an insufficient blood-oxygen level is the primary rationale for hospitalization. (This seems likely to have been true in Trump’s case.) Such patients are monitored closely for changes in oxygen levels and also for other problems that can arise, such as blood clots, heart-muscle damage, bacterial pneumonia, and worsening kidney function. They are likely to receive remdesivir, an antiviral drug, and perhaps the steroid dexamethasone, if their oxygen levels dip low enough. (According to the RECOVERY Trial, a large biostatistical effort in the U.K., dexamethasone may help people who need supplemental oxygen.) We now know that the President has received both remdesivir and dexamethasone; in general, the administration of steroids suggests that a patient is approaching, or has already entered, the second, immune-focused phase of the disease. Still, at this level of illness, a patient might spend a few days on and off small doses of oxygen, delivered through a nasal cannula—a hose with prongs for the nostrils. All this is nerve-racking for patients and their doctors and families, but many people go through this experience and then recover enough to be discharged home.

    In some cases, however, oxygen levels continue to fall. The immune system hasn’t been able to subdue the virus, and has started to overreact, causing collateral damage to blood vessels or organs. Once this happens, the second phase has fully arrived. Doctors monitoring a patient in this situation would be especially concerned if lab tests showed that inflammation was surging within the body, or if a CT scan uncovered a blood clot in the lungs or widespread injury to delicate lung tissue. If a steroid had not already been started, it would be administered now. Doctors might also prescribe a blood-thinning medication to treat or prevent a clot, or antibiotics to kill bacteria that are adding insult to viral injury. They could also introduce more sophisticated oxygen-delivery devices—powerful high-flow nasal cannulas, or “non-rebreather” masks—that can provide much higher doses of oxygen to the lungs. The air we breathe normally is about twenty-one per cent oxygen, and a regular nasal cannula might increase this proportion by a few percentage points—but a high-flow nasal cannula can shoot nearly a hundred per cent oxygen up your nose, at sixty litres a minute.

    If these maneuvers aren’t enough to maintain blood-oxygen levels above ninety per cent, then doctors turn to mechanical ventilators. A tube is snaked down a patient’s throat and into the lungs. All intubated patients are transferred to an I.C.U. The ventilator takes over the work of breathing; doctors treat what they can and hope for the best. Precise estimates of the likelihood that a person will progress from infection to hospitalization to I.C.U. to death are hard to come by, and vary widely. But a recent meta-analysis suggests that about a third of patients with severe covid-19 end up in the I.C.U., and about a third of those in the I.C.U. go on to die. Although mortality rates for patients requiring I.C.U.-level care have declined since the start of the pandemic, they remain distressingly high.

    Because of the scary mortality statistics, the discussion of the President’s illness has often had mortal stakes. The truth, though, is that there’s a vast middle ground of survival, in which patients can beat the virus only to experience residual symptoms and, in some cases, ongoing physical or cognitive deficits. For many covid-19 patients—even those who never move beyond the first phase of the disease—problems such as fatigue and shortness of breath can linger for weeks or months. The risks are much higher for those with severe illness, especially those who end up in the I.C.U. Some patients who recover from covid-19 report fatigue, headaches, memory issues, and breathing and gastrointestinal problems for months after their initial symptoms. Surviving illness and returning to good health are not one and the same.

    From a medical perspective, many questions remain about Trump’s illness; some may be answered in the coming days. One set of questions concerns diagnostic tests that could give us a clearer understanding of the seriousness of the President’s condition and the possibility of decline. Disclosure of a CT scan, for example, could offer meaningful information about whether the coronavirus has injured his lungs. (Conley indicated that the President’s scans have shown “expected findings,” but it wasn’t clear what this meant; notably, he did not say the imaging was normal.) Blood tests that analyze inflammatory molecules could reveal the degree of inflammation in Trump’s body, and offer clues about whether the President has crossed from the first phase of illness to the second. Much of the incomplete diagnostic information provided so far has just raised more questions. Conley has said, for instance, that Trump is getting daily ultrasounds, which is not standard medical practice. Ultrasounds of what, and why? If one of them reveals a blood clot in the legs, or damage to the heart—both relatively common complications of covid-19—that would portend a more serious course for the President. In that case, he might be facing a systemic illness, rather than one confined to the lungs; his immune system may have failed to contain the virus and now be contributing to damage of the blood vessels and other organs.

    A second set of questions revolves around the treatments Trump is receiving. In the absence of clear communication from his medical team, we can try to work backward, using new steps in his treatment to guess at developments in his illness. For now, we know that the President got a dose of REGN-COV2, Regeneron’s experimental antibody drug, on Friday. The drug has not completed Phase III clinical trials, and hasn’t been approved by the F.D.A. or authorized for emergency use; instead, Trump received the medication under a “compassionate use” request. Last week, Regeneron issued a press release indicating that REGN-COV2 has shown promise for reducing the amount of circulating virus in the body and for alleviating symptoms in non-hospitalized patients. Preliminary results suggest that it is relatively safe, and that patients early in the disease course, who haven’t yet mounted their own immune responses, are more likely to benefit from it. (The average age of trial patients, however, was forty-four—thirty years younger than the President.) The company is still testing to find out whether REGN-COV2 helps hospitalized patients, and whether it can prevent infection in those exposed to the virus. The fact that Trump’s team decided to use an unproven drug suggests something about the perceived seriousness of his disease as early as Friday morning.

    The use of dexamethasone is also striking. It likely means that his illness is serious and could be worsening. Dexamethasone can lessen the chances of death for covid-19 patients who are on ventilators or who require supplemental oxygen—but it can be harmful in those without a need for respiratory support. Administering it to someone who isn’t firmly in the second phase of the illness, therefore, involves a careful balancing of risks and trade-offs. It’s a medicine for those with severe disease.

    At this point, it’s not clear what the future holds for the President or the country. covid-19 is dangerous and capricious. If we take the White House physician at his word, Trump’s current condition appears stable—but Conley’s evasiveness has created more uncertainty than understanding. In the meantime, we should prepare for a trickle of unsatisfactory, and sometimes contradictory, information from the President’s team. There may be days with no changes, and they may be followed by sudden positive or negative developments. The daily drama of ferreting out Trump’s oxygen levels and test results is worthwhile, but there are key shifts in his clinical care that will be much more telling: the need for a more powerful oxygen-delivery device, for example, or a transfer to a higher level of care, such as the I.C.U. A relatively long hospital stay, even outside the I.C.U., would also be cause for concern. Alternatively, from here, the President could quickly improve and, as Conley suggested on Sunday, be discharged home. These big shifts are far more medically revelatory than whether the President needed two litres of supplemental oxygen or three, and whether he needed them in the morning or the afternoon.

    In the hospital, when patients with covid-19 ask me about their prognoses, I respond honestly. Together, we talk through the evidence we have and acknowledge the information we lack. For patients of Trump’s age, and at his stage of the disease, I’m usually able to say that there’s a good chance we’ll get the full recovery we hope for. But I also have to be truthful about the uncertainty we face. I try to choose my words carefully. “It’s hard to predict how things will go,” I often say. “We should prepare for a range of possible outcomes.”

    #121542
    Avatar photojoemad
    Participant

    URL = https://www.sfgate.com/politics/article/California-2020-ballot-measures-propositions-guide-15578295.php

    A dummy’s guide to California 2020 ballot measures

    By Eric Ting, SFGATE Updated 4:00 am PDT, Monday, September 21, 2020
    You’ve seen the ads. But you’re not sure what any of these California ballot measures actually do.
    Fear not! Here’s a handy, simple guide to each of the 12 propositions on the California ballot for the November general election. From affirmative action to overturning the highly controversial gig worker bill (AB-5), there are plenty of significant measures California residents will be voting on this fall. This guide is broken into three categories: 1. The big ones that interest groups are dumping millions of advertising dollars into, 2. The criminal justice ones, and 3. The rest.

    THE BIG ONES
    Proposition 16

    What it does: Allows the state and its public universities to discriminate or grant preferential treatment based on race, sex, ethnicity, or national origin in public employment, education, or contracting.
    Major players for it: The University of California Board of Regents, Sens. Kamala Harris and Dianne Feinstein, and various Black Lives Matter-related advocacy groups.
    Major players against it: A number of Asian American groups and Republicans in the California state Assembly.
    Recent polling: 31% support, 47% oppose, 22% undecided (PPIC poll, Sept. 4-Sept 13.)
    New poll finds shaky support for Proposition 16 to restore affirmative action in California (LA Times)
    Proposition 16: Why some Asian Americans are on the front lines of the campaign against affirmative action (Mercury News)

    Proposition 15
    What it does: Raises funds for schools and local governments by requiring commercial and industrial properties with more than $3 million in holdings to be taxed based on market value as opposed to purchase price. Does not impact homeowners.
    Major players for it: Gov. Gavin Newsom, San Francisco Mayor London Breed, and the California Teacher’s Association.
    Major players against it: California Chamber of Commerce, California Small Business Association and several taxpayers’ groups.
    Recent polling: 51% support, 40% oppose, 9% undecided (PPIC poll, Sept. 4-Sept 13.)
    Prop. 15 could raise billions for California, But who will pay? (NBC San Diego)
    Governor’s endorsement of Proposition 15 disappoints Farm Bureau (Lassen County Times)

    Proposition 22
    What it does: Classifies app-based drivers as independent contractors and not employees, which effectively kneecaps AB5.
    Major players for it: Uber, Lyft, DoorDash and other similar services.
    Major players against it: Sen. Kamala Harris, Attorney General Xavier Becerra, and several state Assembly Democrats.
    Recent polling: 41% support, 26% oppose, 34% undecided (Redfield and Wilton poll, Aug. 9)
    Uber and Lyft have poured millions of dollars into a November ballot measure to keep Calif. drivers paid as independent contractors (Business Insider)
    Uber analyst expects California’s Prop. 22 to pass based on latest polling (Yahoo Finance)

    Proposition 21
    What it does: Allows local governments to enact rent control on housing that was first occupied over 15 years ago.
    Major players for it: Sen. Bernie Sanders, Democratic Socialists of America, Los Angeles chapter and various tenants’ groups.
    Major players against it: Gov. Gavin Newsom, California Apartment Association and construction workers’ unions.
    Recent polling: N/A
    Bernie Sanders backs rent control, slams greedy landlords in new ‘yes on 21’ spot (Business Wire)
    Opponents of rent control initiative say Prop. 21 backers violated Stolen Valor Act in ad (San Diego Union Tribune)

    THE CRIMINAL JUSTICE ONES
    Proposition 25

    What it does: Eliminates cash bail and gives judges the ability to determine whether a defendant should be released prior to a trial.
    Major players for it: Gov. Gavin Newsom, several congressional Democrats and civil liberties groups.
    Major players against it: Orange County Board of Supervisors and several groups affiliated with the bail bonds industry.
    Recent polling: 39% support, 32% oppose, 29% undecided (UC Berkeley Institute of Government Studies poll, Sept. 13-Sept.18)
    California’s cash bail system favors the rich. Would replacing it help people of color? (Fresno Bee)
    Prop. 25 will replace cash bail with risk assessment, if passed (Daily Cal)

    Proposition 17
    What it does: Restores voting rights to people with felony convictions who have been released from prison but remain on parole.
    Major players for it: Sen. Kamala Harris, the ACLU of California and many state Assembly Democrats.
    Major players against it: State Sen. Jim Nielsen (R-4) and the Election Integrity Project California.
    Recent polling: N/A
    LA County supervisors support proposition restoring voting rights to those on parole (CBS Los Angeles)
    Alex Padilla: Why Prop. 17 will strengthen both voting rights and public safety (San Diego Union Tribune)

    Proposition 20
    What it does: Adds several crimes to the list of violent felonies for which early parole is restricted. Would undo a series of reforms enacted between 2011 and 2016 aimed at reducing the state’s prison population.
    Major players for it: Assemblyman Jim Cooper (D-9) and multiple law-enforcement-affiliated groups.
    Major players against it: Former Gov. Jerry Brown, the ACLU of California and several criminal justice reform advocacy groups.
    Recent polling: N/A
    Grocery stores are pushing California to be tougher on crime (LA Times)
    Opposition to Prop. 20 increases; opponents charge it’s a step backward for CA (Davis Vanguard)

    THE REST
    Proposition 19

    What it does: Allows homeowners over the age of 55, disabled or victims of a natural disaster to take existing, lower property tax rates to new homes anywhere in the state.
    Major players for it: California Realtors Association, California Professional Firefighters and several local real estate groups.
    Major players against it: Howard Jarvis Taxpayers Association.

    Recent polling: N/A

    Links to learn more:
    Prop. 19 debate: Funding for fighting wildfires or attack on Prop 13 tax protections? (CBS San Francisco)
    Worried about fires? California ballot initiative could help you move to a new city (Sacramento Bee)

    Proposition 24
    What it does: Expands the state’s consumer data privacy laws by creating a new state agency to enforce privacy laws, empowering consumers to order that businesses not sell their personal information, and increasing financial penalties on those who violate privacy laws.
    Major players for it: Former Democratic presidential candidate Andrew Yang and several online privacy groups.
    Major players against it: ACLU of California and the Consumer Federation of California.
    Recent polling: N/A
    Links to learn more:
    Andrew Yang takes lead role in California data privacy campaign (Politico)
    Prop. 24 seemingly seeks to expand internet privacy, critics say it won’t (Salinas Californian)

    Proposition 18
    What it does: Allows 17-year-old Californians who will be 18 by the following general election to vote in primaries and special elections.
    Major players for it: California Secretary of State Alex Padilla and Assembyman Kevin Mullin (D-22).
    Major players against it: The Election Integrity Project California.
    Recent polling: N/A
    Links to learn more:
    Alex Padilla: Vote yes on Prop. 18 to engage, energize and empower the next generation of voters (San Diego Union Tribune)
    Thousands of 17-year-olds could vote in California primaries if initiative passes, study says (Sacramento Bee)

    Proposition 14
    What it does: Issues $5.5 billion in general obligation bonds for the state’s stem cell research institute.
    Major players for it: Californians for Stem Cell Research, Treatments & Cures and the University of California Board of Regents.
    Major players against it: The Center for Genetics and Society
    Recent polling: N/A
    Link to learn more:
    Prop. 14: There’s much, much more than meets the eye (Capitol Weekly)

    Proposition 23
    What it does: Places several new regulations on dialysis clinics, including requiring an on-site physician, mandating increased reporting of dialysis-related infections, and not allowing clinics to close before obtaining consent from the state health department.
    Major players for it: Californians for Kidney Dialysis Patient Protection
    Major players against it: American Legion, California Medical Association and several veterans’ and health groups.
    Link to learn more:
    Prop. 23: Kidney dialysis clinic rules (Cal Matters)

    #121215
    Avatar photozn
    Moderator

    COVID is not a great equalizer

    link https://www.kevinmd.com/blog/2020/05/covid-is-not-a-great-equalizer.html?xid=fb-md-cbtm-onc-opd&fbclid=IwAR18HuWb_SDBCM9H4VJyJ6dp7ZHwaYDf-diMekOEQtbvF8fBvtYtzdgDuXc

    Some media outlets and public figures have heralded the ongoing pandemic as a great equalizer, referencing the pathogen’s indiscriminate spread and disregard for national borders and tax brackets.

    The sobering mortality statistics, however, dispense any notion of an equal-opportunity crisis, revealing a familiar theme among public health challenges in America: significant racial disparities exist, and communities of color are disproportionately affected.

    CDC data show that blacks account for 29% of confirmed infections despite comprising 14% of the general population. An Associated Press analysis of 3,300 deaths in early April found 42% of the victims were black, and a recent study estimated the mortality rate for blacks at 2.7 times that for whites.

    What explains this dramatic difference in outcomes? It is a complex question that hints at a series of economic, environmental, and health care realities, reinforced by bias, that have plagued black Americans long before the novel coronavirus emerged. This crisis is a microcosm of historical racial disparities in society, forged by decades of systemic racism and discriminatory public policy. Given this milieu of health-associated inequalities, the strikingly lopsided death rate by ethnicity is not just predictable, but inevitable.

    Any discussion of health disparities must begin with economic factors, which contribute heavily to the outsized impact of the pandemic on minorities. Black families earn 71 cents of take-home income and hold 32 cents in liquid assets per dollar compared to white families, and 22% of those under the federal poverty level are black.

    Given the higher poverty rate, lower-income status, and wealth deficit faced by the black community, a crippled economy can make compliance with stay-at-home orders financially unviable. Furthermore, blacks are overrepresented among low-wage and “gig” workers relative to their share of overall employment, are more often paid hourly, and infrequently benefit from sick leave policies relative to whites. While non-essential staff can “telecommute” and earn wages remotely, self-isolation is unrealistic for many essential workers, who must weigh the threat of infection against the possibility of termination.

    Environmental influences further exacerbate the vulnerability of black Americans, who commonly reside in urban settings and represent a higher proportion of public housing residents.

    Such areas are often overcrowded and under-funded, with major environmental hazards such as air pollution, poor water quality, lead, pests, and mold. Predictably, blacks have higher rates of chronic lung disease and die nearly thrice as often from asthma as whites.

    Growing literature on COVID-19 has established that patients with underlying health conditions are subject to a higher risk of hospitalization and adverse outcomes. Additionally, the high population density in housing projects, shelters, and jails—inhabitants of which are predominately black in the U.S, a legacy of discriminatory housing practices, racist policies such as redlining, and deep-seated inequities in our criminal justice system—make social distancing virtually impossible.

    Finally, inadequate access to food due to issues with location, transportation, or infrastructure further compromises health in black communities. Even before coronavirus caused mass unemployment and overwhelmed food pantries, black households were twice as likely to suffer from food insecurity versus the national average. Greater exposure to food deserts and hazardous, cramped living conditions that preclude appropriate distancing make communities of color uniquely susceptible to outbreaks like this one.

    Health-wise, blacks are more likely to have chronic conditions and limited access to care. Studies show that “black patients are 40% more likely to have high blood pressure, twice as likely to have heart failure … three times more likely to have chronic kidney disease, twice as likely to be diagnosed with colon and prostate cancer.”

    A CDC report found that a startling 89% of hospitalized COVID-19 patients had one or more pre-existing conditions. It is then especially troublesome that black Americans are less likely to have adequate insurance or receive employer-sponsored coverage.

    The inability or unwillingness to pursue testing or evaluation portends advanced presentation, hospitalization, and poorer outcomes with infection.

    While features of the economy, the built environment, individual health, and access to care render black Americans more susceptible to the novel coronavirus, bias — implicit and explicit — has long driven health disparities among minorities. Consider the curious concept of “allostatic load,” i.e., the physiological cost of chronic stress on the human body over time. Persistent activation of hormone-driven homeostatic mechanisms can overload vital organs, impair the immune system, and generate systemic pathology.

    Discrimination and bias are significant stressors, and studies have linked them to higher rates of inflammation among black adults, perhaps also contributing to over-representation among confirmed coronavirus cases. Furthermore, there is robust literature suggesting that black patients are not treated equally once hospitalized, getting less pain medication, undergoing fewer procedures, receiving less explanation, and experiencing poorer quality of care compared to white patients.

    One concerning study found a substantial number of white people, from laymen to residents, believe biological differences between races yield differing pain thresholds. Racism and unconscious bias have undergirded the policies and practices that allowed latent racial inequities in health care to fester, and the uneven COVID death toll reminds us as a medical community that there is a long way to go.

    Rather than level the playing field, the coronavirus pandemic has exposed and intensified race-based inequities inherent in our health care system and society, fossilized over decades of neglect, de-prioritization, and otherization of communities of color. I have endeavored to highlight inextricable economic, environmental, health-related, and psychological forces that drive poorer health outcomes for black Americans overall and may provide a framework to discuss the disproportionate numbers testing positive and dying during this crisis. These factors engender higher vulnerability through increased risk of exposure and transmission, decreased immunity from stress, acute presentations due to underlying conditions and subpar access to care, and possible discrepancies in treatment upon hospitalization.

    Perhaps there is a silver lining. With the pandemic throwing the differential experience of black people in terms of health and health care into sharp relief, the issue may achieve the critical mass of attention necessary to meaningfully address these deep-seated disparities. Only then can we truly dub this coronavirus a great equalizer.

    #120401
    Avatar photoZooey
    Moderator

    I’m not sure this blog post belongs here, but it’s about Trump, and I agree with it, and wanted to share it.

    https://taibbi.substack.com/p/the-trump-era-sucks-and-needs-to

    The Trump Era Sucks and Needs to Be Over
    The race is tightening. Is America sure it’s ready to give up its addiction to crazy?
    Matt Taibbi
    23 hr
    513
    668

    In Donald Trump’s interview with Laura Ingraham last week, he talked about the “shadow people” he believes lurk behind Joe Biden:

    INGRAHAM: Who do you think is pulling Biden’s strings? Is it former Obama officials?

    TRUMP: People that you’ve never heard of. People that are in the dark shadows.

    Fifteen years ago, the Fox News personality was likely to be the one pushing the conspiratorial envelope. Glenn Beck playing with rubber frogs while railing about assassination plots or spinning elaborate tales connecting Barack Obama to both Hitler and Stalin represented the outward edge of crazy in mainstream discourse.

    Today the Fox anchor is the voice of restraint, pleading with the President of the United States to stay on planet earth while cameras roll:

    INGRAHAM: What does that mean? That sounds like conspiracy theory.

    TRUMP: No, people that you haven’t heard of. They’re people that are on the streets. They’re people that are controlling the streets…

    We’ve been living with Trump for so long, we’ve gotten out of the habit of asking the basic questions we normally ask, when a famous person says something odd. What is he thinking? Is he being serious? Does he mean this as metaphor — is he talking about the donors and party higher-ups who may indeed have outsize influence behind his elderly opponent’s candidacy — or does he really believe in a nebulous, Three Days of the Condor-style secret spooks’ club, working after hours to install a socialist dictatorship through Joe Biden?

    Donald Trump is so unlike most people, and so especially unlike anyone raised under a conventional moral framework, that he’s perpetually misdiagnosed. The words we see slapped on him most often, like “fascist” and “authoritarian,” nowhere near describe what he really is, and I don’t mean that as a compliment. It’s been proven across four years that Trump lacks the attention span or ambition required to implement a true dictatorial regime. He might not have a moral problem with the idea, but two minutes into the plan he’d leave the room, phone in hand, to throw on a robe and watch himself on Fox and Friends over a cheeseburger.

    The elite misread of Trump is egregious because he’s an easily familiar type to the rest of America. We’re a sales culture and Trump is a salesman. Moreover he’s not just any salesman; he might be the greatest salesman ever, considering the quality of the product, i.e. himself. He’s up to his eyes in balls, and the parts of the brain that hold most people back from selling schlock online degrees or tchotchkes door-to-door are absent. He has no shame, will say anything, and experiences morality the way the rest of us deal with indigestion.

    Pundits keep trying to understand him by reading political scare-tracts like The Origins of Totalitarianism or It Can’t Happen Here, but again, the books that explain Trump better tend to be about things like pro wrestling (like Controversy Creates Cash or The Business of Kayfabe) or the psychology of selling (like Pre-Suasion or Thinking Fast and Slow). The people howling about outrageous things Trump says probably never sat in a sales meeting. In Pre-Suasion, psychology professor Robert Cialdini, who went undercover with salespeople to discover their secrets, describes how one got clients to agree to his company’s $75,000 fee:

    Instead, after his standard presentation… he joked, “As you can tell, I’m not going to be able to charge you a million dollars for this.” The client looked up from his written proposal and said, “Well, I can agree to that!” The meeting proceeded without a single subsequent reference to compensation and ended with a signed contract…

    Sound familiar? When Trump first hit the campaign trail in 2015-2016, reporters were staggered by the outrageous promises Trump would toss out, like that he’d slap a 45% tariff on all Chinese products, build a “high” wall across the Mexican isthmus, or deport all 11.3 million undocumented immigrants (“They have to go,” he told Chuck Todd).

    Those of us with liberal arts educations and professional-class jobs often have trouble processing this sort of thing. If you work in a hospital and someone asks you a patient’s hematocrit level, no one expects you to open with fifteen times the real number. But this is a huge part of Trump’s M.O.

    By the end of the 2016 race, some of us in media were struggling with what to tell readers about Trump’s intentions, given that he would frequently offer contradictory proposals (with matching impassioned explanations) within minutes of each other, sometimes even within the same sentence. He would tell one crowd to whoops and hollers that he couldn’t wait to throw all them illegals back over the river, then go on Hannity that same night and say he was open to a “softening” on immigration:

    Everybody agrees we get the bad ones out… But when I meet thousands and thousands of people on this subject…they’ve said, ‘Mr. Trump, I love you, but to take a person that has been here for 15 or 20 years and throw them and the family out, it’s so tough, Mr. Trump.’

    Read what sales books have to say about morality or belief systems and Trump starts to make even more sense. What did Cialdini notice about John Lennon’s idealistic clarion call, Imagine? That Lennon increased his chances of selling political change with the line, “But I’m not the only one…” It turns out you can increase demand for anything from government policies to items on a Chinese menu simply by asserting, as Trump constantly does, that “everybody’s talking about it.” Ask students to draw long and short lines on a piece of paper, and when asked, the people drawing long ones think the Mississippi River is longer. Trump’s constant invocations about a future of “so much winning” worked, even with people who tried consciously to dismiss it as bullshit.

    Read Brian Tracy’s The Psychology of Selling and you learn that the key to closing a sale not only involves identifying the “needs of your prospect,” but making sure to promise a big enough change to make action seem worth it:

    The customer must be substantially better off with your product or service than he is without it. It cannot represent a small increment in value or benefit… [it must be] great enough to justify the amount of money you are charging, plus the amount of time and energy it will take to implement your solution.

    The question, “What is Trump thinking?” is the wrong one. He’s not thinking, he’s selling. What’s he selling? Whatever pops into his head. The beauty of politics from his point of view, compared to every other damn thing he’s sold in his life — steaks, ties, pillows, college degrees, chandeliers, hotels, condominiums, wine, eyeglasses, deodorant, perfume (SUCCESS by Trump!), mattresses, etc. — is that there’s no product. The pitch is the product, and you can give different pitches to different people and they all buy.

    In 2016 Trump reeled in the nativist loons and rage cases with his opening rants about walls and mass deportations, then slowly clawed his numbers up with the rest of the party with his “softening” routine. Each demographic probably came away convinced he was lying to the other, while the truth was probably more that he was lying to all of them. Obviously there are real-world consequences to courting the lowest common denominator instincts in people, but to Trump speeches aren’t moral acts in themselves, they’re just “words that he is saying,” as long-ago spokesperson Katrina Pierson put it.

    In this sense the Republican Party’s 2020 platform is genius: there isn’t one, just a commitment to “enthusiastically support the President’s America-first agenda,” meaning whatever Trump says at any given moment. If one can pull back enough from the fact that this impacts our actual lives, it’s hard not to admire the breathtaking amorality of this, as one might admire a simple malevolent organism like a virus or liver fluke.

    Trump blew through the Republican primaries in 2015-2016. His opponents, a slate of mannequins hired by energy companies and weapons contractors to be pretend-patriots and protectors of “family values,” had no answer for his insults and offer-everything-to-everyone tactics. Like most politicians, they’d been protected their whole lives by donors, party hacks, and pundits who’d turned campaigns into a club system designed to insulate paid lackeys from challenges to their phony gravitas. Trump had no institutional loyalty to the club, shat all over it in addition to its silly frontmen, and walked to the nomination.

    So long as he was never going to win the actual presidency, this was funny. The Republicans deserved it. Watching GOP chair Reince Priebus try to pretend he wasn’t being forced to eat the biggest-in-history shit sandwich by embracing his obese conqueror at the 2016 convention was a delicious scene, similar to what most Americans probably felt watching Bill Belichick squirm at the podium after the Eagles pummeled him in the Super Bowl.

    The Democrats aren’t much better, though, and the spectacle of “inevitable” Hillary Clinton being too shocked to ascend to the Javits Center podium, instead sending writhing campaign creature John Podesta to announce through a forced smile that the mortified audience shouldn’t worry and should get some sleep instead, was also high comedy, not that I really saw it at the time.

    They all deserved it, every last politician ruined that year. The country did not, however, which is why the last four years have been a nightmare beyond all recognition. The joke ended up being on us.

    The paradox ensnaring America since November, 2016 is that Trump never intended to govern, while his opponents never intended to let him try. In an alternate universe where a post-election Donald had enough self-awareness to admit he was out of his depth, and the D.C. establishment agreed to recognize his administration as legitimate for appearances’ sake, Trump might have escaped four years with the profile of a conventionally crappy president, or perhaps a few notches below that — way below average, maybe, but survivable.

    Instead it was decided even before he was elected that admitting the president was the president was “normalizing” him. Normally no news is good news, and the anchorman is encouraged to smile on a day without war, earthquakes, terror attacks, or stock market crashes. Under Trump it became taboo to have a slow news day. A lack of an emergency was a failure of reporting, since Trump’s very presence in office was crisis.

    We spent four years moving from panic to panic, from the pee story to the Muslim ban to Michael Flynn’s firing to the Schiff hearings in March 2017 to Jim Comey’s dismissal to Treason in Helsinki to Charlottesville to the caravan to the Kavanaugh hearings and beyond. When Trump fired Jeff Sessions, perhaps the most determined enemy of police reform in recent history — one of his last acts as Attorney General was issuing an order undermining federal civil rights investigations — liberal America exploded in media-driven street protests:

    The problem was this all played into Trump’s hands. Instead of crafting a coherent, accessible plan to address the despair and cynicism that moved voters to even consider someone like Trump in the first place, Democrats instead turned politics into a paranoiac’s dream, imbuing Trump’s every move with earth-shattering importance as America became a single, never-ending, televised referendum on His Orangeness.

    The last four years have been like living through an O.J. trial where O.J. testifies all day (and tweets at night). Not only has this been maddening to those of us who desire a more Trumpless existence, especially since it’s constantly implied that being anything less than enthralled by the Trump show is an inexcusable show of privilege, it’s massively increased the chances of the whole exhausting spectacle continuing, by giving Trump something to run on again.

    Ever since Trump jumped into politics, the pattern has been the same. He enters the arena hauling nothing but negatives and character liabilities, but leaves every time armed with winnable issues handed to him by overreacting opponents.

    His schtick is to provoke rivals to the point where they drop what they’re doing and spend their time screaming at him, which from the jump validates the primary tenet of his worldview, i.e. that everything is about him. Political opponents seem incapable of not handing him free advertising. They say his name on TV thousands of times a day, put his name on bumper stickers to be paraded before new demographics (e.g. “BERNIE BEATS TRUMP”), and then keep talking about him even off duty, at office parties, family dinners, kids’ sports events, everywhere, which sooner or later gets people wondering: who’s more annoying, the blowhard, or the people who can’t stop talking about the blowhard?

    Nearly the whole of Trump’s case for re-election in 2020 comes from the wreckage of these endless, oft-overheated Spy vs. Spy-style intrigues against him. What would he be running on, if he didn’t have Russiagate, “fake news,” and impeachment? When the Democrats failed to bring the latter up even once during the recent DNC, conspicuously disinviting key impeachment players like Adam Schiff and Tom Steyer, it made Trump’s martyrdom argument for him: if Ukraine was the Most Important Issue In the Universe just eight months ago, where is it now?

    American politics has become an interminable clash of off-putting pathologies. Call it the hydroxychloroquine effect. Trump one day in a press conference mutters that a drug has “tremendous promise” as a treatment of coronavirus. Within ten seconds a consensus forms that hydroxycholoroquine is snake oil, and the New York Times is running stories denouncing Trump’s “brazen willingness to distort and outright defy expert opinion and scientific evidence when it does not suit his agenda.”

    Then you read the story and find out doctors have been prescribing the drug, that “early reports from doctors in China and France have said that [it] seemed to help patients,” and moreover that the actual quote about it being a “game changer” from Trump included the lines, “Maybe not” and “What do I know? I’m not a doctor.” In response to another Trump quote on the subject, “What do you have to lose?” journalists piled on again, quoting the president of the American Medical Association to remind audiences “you could lose your life” — as if Trump had recommended that people run outside and mainline the stuff.

    Trump being Trump, he responded to this criticism by doubling down over and over, eventually re-tweeting a video boosting the drug by a doctor named Stella Immanuel. She turned out to believe that alien DNA had been used in medical treatments, atheist doctors were working on a religion vaccine, and uterine endometriosis is caused by demon sperm. Asked about this “misinformation,” Trump somehow managed to include both a xenophobic putdown about the Nigerian doctor and a lie about his enthusiasm for her, saying, “I don’t know what country she comes from… I know nothing about her.”

    All of which is insane, but so is rooting for a drug to not work in the middle of a historic pandemic, the clear subtext of nearly every news story on this topic dating back to March. Rule #1 of the Trump era is that everything Trump touches quickly becomes as infamous as he is, maybe not the biggest deal when talking about an obscure anti-malarial drug, but problematic when the subject is America itself.

    Trump’s argument is, “They lie about me.” He attracts so much negative attention, and so completely dominates the culture, that the line between him and the country that elected him becomes blurred, allowing him to make a secondary argument: “They lie about you.” This incantation works. The New York Times just ran a story about how “Chaos in Kenosha is already swaying some voters” that quoted John Geraghty, a former Marine. Geraghty’s first vote was for Barack Obama, and called Trump’s handling of coronavirus “laughable,” but still:

    Mr. Geraghty said he disliked how Mr. Trump talked but said the Democratic Party’s vision for governing seemed limited to attacking him and calling him a racist, a charge being leveled so constantly that it was having the effect of alienating, instead of persuading, people. And the idea that Democrats alone were morally pure on race annoyed him.

    With the election just a few months away, the country is coming apart at the seams. In addition to a pandemic, an economic disaster, and cities simmering on the edge of civil war, we’re nursing what feels like a broken culture. Life under Trump has been like an endless Twitter war: infuriating, depressing, filling us all with self-loathing, but also addictive. He is selling an experience that everyone is buying, even the people who think they oppose him the most.

    My worry is with that last part. Institutional America is now organized around a Trump-led America. The news media will lose billions with him gone (and will be lost editorially). The Democratic Party has no message — literally none — apart from him. A surging activist movement will be deflated without him, along with a host of related fundraising groups and businesses (watch what happens to “dismantling white supremacy training” in a non-Trump context).

    It feels like a co-dependent relationship, and the tightening poll numbers in battleground states make me wonder about self-sabotage. He’ll likely still lose, but this is all beginning to feel like a slow-motion rerun of the same car crash from four years ago, when resentment, rubbernecking, and lurid fascination pulled him just across the finish line. People claim to hate him, but they never turn off the show in time, not grasping that Trump always knows how to turn their negative attention into someone else’s vote.

    Isn’t four years of this enough? I don’t even care anymore whose fault it is: Trump has made us all crazy, and it’s time for the show to be over. We deserve slow news days again.

    © 2020 Matt Taibbi. See privacy, terms and information collection notice
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    A Supercomputer Analyzed Covid-19 — and an Interesting New Theory Has Emerged
    A closer look at the Bradykinin hypothesis[/b]

    https://elemental.medium.com/a-supercomputer-analyzed-covid-19-and-an-interesting-new-theory-has-emerged-31cb8eba9d63

    Earlier this summer, the Summit supercomputer at Oak Ridge National Lab in Tennessee set about crunching data on more than 40,000 genes from 17,000 genetic samples in an effort to better understand Covid-19. Summit is the second-fastest computer in the world, but the process — which involved analyzing 2.5 billion genetic combinations — still took more than a week.
    When Summit was done, researchers analyzed the results. It was, in the words of Dr. Daniel Jacobson, lead researcher and chief scientist for computational systems biology at Oak Ridge, a “eureka moment.” The computer had revealed a new theory about how Covid-19 impacts the body: the bradykinin hypothesis. The hypothesis provides a model that explains many aspects of Covid-19, including some of its most bizarre symptoms. It also suggests 10-plus potential treatments, many of which are already FDA approved. Jacobson’s group published their results in a paper in the journal eLife in early July.
    According to the team’s findings, a Covid-19 infection generally begins when the virus enters the body through ACE2 receptors in the nose, (The receptors, which the virus is known to target, are abundant there.) The virus then proceeds through the body, entering cells in other places where ACE2 is also present: the intestines, kidneys, and heart. This likely accounts for at least some of the disease’s cardiac and GI symptoms.

    But once Covid-19 has established itself in the body, things start to get really interesting. According to Jacobson’s group, the data Summit analyzed shows that Covid-19 isn’t content to simply infect cells that already express lots of ACE2 receptors. Instead, it actively hijacks the body’s own systems, tricking it into upregulating ACE2 receptors in places where they’re usually expressed at low or medium levels, including the lungs.
    In this sense, Covid-19 is like a burglar who slips in your unlocked second-floor window and starts to ransack your house. Once inside, though, they don’t just take your stuff — they also throw open all your doors and windows so their accomplices can rush in and help pillage more efficiently.
    The renin–angiotensin system (RAS) controls many aspects of the circulatory system, including the body’s levels of a chemical called bradykinin, which normally helps to regulate blood pressure. According to the team’s analysis, when the virus tweaks the RAS, it causes the body’s mechanisms for regulating bradykinin to go haywire. Bradykinin receptors are resensitized, and the body also stops effectively breaking down bradykinin. (ACE normally degrades bradykinin, but when the virus downregulates it, it can’t do this as effectively.)
    The end result, the researchers say, is to release a bradykinin storm — a massive, runaway buildup of bradykinin in the body. According to the bradykinin hypothesis, it’s this storm that is ultimately responsible for many of Covid-19’s deadly effects. Jacobson’s team says in their paper that “the pathology of Covid-19 is likely the result of Bradykinin Storms rather than cytokine storms,” which had been previously identified in Covid-19 patients, but that “the two may be intricately linked.” Other papers had previously identified bradykinin storms as a possible cause of Covid-19’s pathologies.
    As bradykinin builds up in the body, it dramatically increases vascular permeability. In short, it makes your blood vessels leaky. This aligns with recent clinical data, which increasingly views Covid-19 primarily as a vascular disease, rather than a respiratory one. But Covid-19 still has a massive effect on the lungs. As blood vessels start to leak due to a bradykinin storm, the researchers say, the lungs can fill with fluid. Immune cells also leak out into the lungs, Jacobson’s team found, causing inflammation.
    And Covid-19 has another especially insidious trick. Through another pathway, the team’s data shows, it increases production of hyaluronic acid (HLA) in the lungs. HLA is often used in soaps and lotions for its ability to absorb more than 1,000 times its weight in fluid. When it combines with fluid leaking into the lungs, the results are disastrous: It forms a hydrogel, which can fill the lungs in some patients. According to Jacobson, once this happens, “it’s like trying to breathe through Jell-O.”
    This may explain why ventilators have proven less effective in treating advanced Covid-19 than doctors originally expected, based on experiences with other viruses. “It reaches a point where regardless of how much oxygen you pump in, it doesn’t matter, because the alveoli in the lungs are filled with this hydrogel,” Jacobson says. “The lungs become like a water balloon.” Patients can suffocate even while receiving full breathing support.
    The bradykinin hypothesis also extends to many of Covid-19’s effects on the heart. About one in five hospitalized Covid-19 patients have damage to their hearts, even if they never had cardiac issues before. Some of this is likely due to the virus infecting the heart directly through its ACE2 receptors. But the RAS also controls aspects of cardiac contractions and blood pressure. According to the researchers, bradykinin storms could create arrhythmias and low blood pressure, which are often seen in Covid-19 patients.
    The bradykinin hypothesis also accounts for Covid-19’s neurological effects, which are some of the most surprising and concerning elements of the disease. These symptoms (which include dizziness, seizures, delirium, and stroke) are present in as many as half of hospitalized Covid-19 patients. According to Jacobson and his team, MRI studies in France revealed that many Covid-19 patients have evidence of leaky blood vessels in their brains.
    Bradykinin — especially at high doses — can also lead to a breakdown of the blood-brain barrier. Under normal circumstances, this barrier acts as a filter between your brain and the rest of your circulatory system. It lets in the nutrients and small molecules that the brain needs to function, while keeping out toxins and pathogens and keeping the brain’s internal environment tightly regulated.
    If bradykinin storms cause the blood-brain barrier to break down, this could allow harmful cells and compounds into the brain, leading to inflammation, potential brain damage, and many of the neurological symptoms Covid-19 patients experience. Jacobson told me, “It is a reasonable hypothesis that many of the neurological symptoms in Covid-19 could be due to an excess of bradykinin. It has been reported that bradykinin would indeed be likely to increase the permeability of the blood-brain barrier. In addition, similar neurological symptoms have been observed in other diseases that result from an excess of bradykinin.”
    Increased bradykinin levels could also account for other common Covid-19 symptoms. ACE inhibitors — a class of drugs used to treat high blood pressure — have a similar effect on the RAS system as Covid-19, increasing bradykinin levels. In fact, Jacobson and his team note in their paper that “the virus… acts pharmacologically as an ACE inhibitor” — almost directly mirroring the actions of these drugs.

    By acting like a natural ACE inhibitor, Covid-19 may be causing the same effects that hypertensive patients sometimes get when they take blood pressure–lowering drugs. ACE inhibitors are known to cause a dry cough and fatigue, two textbook symptoms of Covid-19. And they can potentially increase blood potassium levels, which has also been observed in Covid-19 patients. The similarities between ACE inhibitor side effects and Covid-19 symptoms strengthen the bradykinin hypothesis, the researchers say.
    ACE inhibitors are also known to cause a loss of taste and smell. Jacobson stresses, though, that this symptom is more likely due to the virus “affecting the cells surrounding olfactory nerve cells” than the direct effects of bradykinin.
    Though still an emerging theory, the bradykinin hypothesis explains several other of Covid-19’s seemingly bizarre symptoms. Jacobson and his team speculate that leaky vasculature caused by bradykinin storms could be responsible for “Covid toes,” a condition involving swollen, bruised toes that some Covid-19 patients experience. Bradykinin can also mess with the thyroid gland, which could produce the thyroid symptoms recently observed in some patients.
    The bradykinin hypothesis could also explain some of the broader demographic patterns of the disease’s spread. The researchers note that some aspects of the RAS system are sex-linked, with proteins for several receptors (such as one called TMSB4X) located on the X chromosome. This means that “women… would have twice the levels of this protein than men,” a result borne out by the researchers’ data. In their paper, Jacobson’s team concludes that this “could explain the lower incidence of Covid-19 induced mortality in women.” A genetic quirk of the RAS could be giving women extra protection against the disease.
    The bradykinin hypothesis provides a model that “contributes to a better understanding of Covid-19” and “adds novelty to the existing literature,” according to scientists Frank van de Veerdonk, Jos WM van der Meer, and Roger Little, who peer-reviewed the team’s paper. It predicts nearly all the disease’s symptoms, even ones (like bruises on the toes) that at first appear random, and further suggests new treatments for the disease.
    As Jacobson and team point out, several drugs target aspects of the RAS and are already FDA approved to treat other conditions. They could arguably be applied to treating Covid-19 as well. Several, like danazol, stanozolol, and ecallantide, reduce bradykinin production and could potentially stop a deadly bradykinin storm. Others, like icatibant, reduce bradykinin signaling and could blunt its effects once it’s already in the body.
    Interestingly, Jacobson’s team also suggests vitamin D as a potentially useful Covid-19 drug. The vitamin is involved in the RAS system and could prove helpful by reducing levels of another compound, known as REN. Again, this could stop potentially deadly bradykinin storms from forming. The researchers note that vitamin D has already been shown to help those with Covid-19. The vitamin is readily available over the counter, and around 20% of the population is deficient. If indeed the vitamin proves effective at reducing the severity of bradykinin storms, it could be an easy, relatively safe way to reduce the severity of the virus.
    Other compounds could treat symptoms associated with bradykinin storms. Hymecromone, for example, could reduce hyaluronic acid levels, potentially stopping deadly hydrogels from forming in the lungs. And timbetasin could mimic the mechanism that the researchers believe protects women from more severe Covid-19 infections. All of these potential treatments are speculative, of course, and would need to be studied in a rigorous, controlled environment before their effectiveness could be determined and they could be used more broadly.
    Covid-19 stands out for both the scale of its global impact and the apparent randomness of its many symptoms. Physicians have struggled to understand the disease and come up with a unified theory for how it works. Though as of yet unproven, the bradykinin hypothesis provides such a theory. And like all good hypotheses, it also provides specific, testable predictions — in this case, actual drugs that could provide relief to real patients.
    The researchers are quick to point out that “the testing of any of these pharmaceutical interventions should be done in well-designed clinical trials.” As to the next step in the process, Jacobson is clear: “We have to get this message out.” His team’s finding won’t cure Covid-19. But if the treatments it points to pan out in the clinic, interventions guided by the bradykinin hypothesis could greatly reduce patients’ suffering — and potentially save lives.

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